Active NPI
Reform Abq
- Medical Specialty Clinic/Center
- Albuquerque, NM
National Provider Identifier
1629803192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Specialty Clinic/Center
- Legal business name
- REFORM ABQ
- Practice address
- 200 Oak St NE Ste 7
Albuquerque, NM 87106-4353 - Phone
- (505) 420-6979
- NPI assigned
- Sep 4, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dee M Cagley
- Title
- Billing Manager
- Phone
- (714) 421-9316
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Care Agency | 251J00000X | |||
| Clinic/Center | 261Q00000X | |||
| Medical Specialty Clinic/Center | 261QM2500X | Primary | ||
| Family Health Clinical Nurse Specialist | 364SF0001X |
Addresses
Primary practice location
200 Oak St NE Ste 7
Albuquerque, NM 87106-4353
Mailing address
200 Oak St NE Ste 7
Albuquerque, NM 87106-4353
Phone (505) 420-6979
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 32D2251240 | Reform Abq, LLC | Certificate of waiver | Jan 31, 2028 |
National Provider Directory
National Provider DirectoryLocations
200 Oak St NE
Ste 7
Albuquerque, NM 87106
Phone (505) 420-6979
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Albuquerque, NM
- NPI 1396393898
-
- General Practice Registered Nurse
- Albuquerque, NM
- NPI 1831957588
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725408000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1725408000000",
"number": "1629803192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 OAK ST NE STE 7",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064353",
"telephone_number": "505-420-6979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 OAK ST NE STE 7",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871064353",
"telephone_number": "505-420-6979"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "REFORM ABQ",
"organizational_subpart": "NO",
"enumeration_date": "2024-09-04",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A",
"authorized_official_last_name": "CAGLEY",
"authorized_official_first_name": "DEE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "714-421-9316"
},
"taxonomies": [
{
"code": "251J00000X",
"taxonomy_group": "",
"desc": "Nursing Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QM2500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Medical Specialty",
"state": null,
"license": null,
"primary": true
},
{
"code": "364SF0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Family Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.