NPIMap

Organization Active NPI

Rio Abajo Family Practice, P.C.

  • Family Medicine Physician
  • Los Lunas, NM
National Provider Identifier
1649288713
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RIO ABAJO FAMILY PRACTICE, P.C.
Practice address
111 Sandoval Rd SW
Los Lunas, NM 87031-7320
Phone
(505) 565-4355
Fax
(505) 565-4360
NPI assigned
Aug 4, 2006
Last updated
Nov 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bobbi Harris
Title
Practice Administrator
Phone
(505) 507-2509

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Medical-Surgical Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SM0705X

Addresses

Primary practice location

111 Sandoval Rd SW
Los Lunas, NM 87031-7320

Mailing address

PO Box 3469
Los Lunas, NM 87031-3469
Phone (505) 565-4355

Other identifiers 4

IdentifierTypeStateIssuer
32D0976095OtherNMCLIA
000B4213MedicaidNM
CH0715OtherNMRAILROAD MEDICARE
201052442OtherNMPRESBYTERIAN HEALTH PLAN

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1649288713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3469",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870313469",
            "telephone_number": "505-565-4355",
            "fax_number": "505-565-4360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 SANDOVAL RD SW",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317320",
            "telephone_number": "505-565-4355",
            "fax_number": "505-565-4360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO ABAJO FAMILY PRACTICE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "BOBBI",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "505-507-2509"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SM0705X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "32D0976095",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000B4213",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH0715",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH PLAN",
            "identifier": "201052442",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.