Brenda James, MD
Individual provider Active NPI Pediatrics Physician · Farmington, NM
NPI 1649366105 · NPPES record last updated Mar 27, 2013
Key facts
- NPI
- 1649366105
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 2003-0194 (NM)
- Practice address
- 407 S Schwartz Ave
Ste 102
Farmington, NM 87401 - Phone
- (505) 609-6700
- Fax
- (505) 609-6701
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003-0194 | NM | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan Regional Medical Center Inc | Past | Accepting new patients | |
| San Juan Regional Medical Center Inc | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 2003-0194 | NM | Yes |
Addresses
Primary practice location
407 S Schwartz Ave
Ste 102
Farmington, NM 87401
Mailing address
PO Box 6210
Farmington, NM 87499
Phone (505) 609-2258
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37320777 | Medicaid | NM |
NPI Registry JSON
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364342400000",
"number": "1649366105",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6210",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "87499",
"telephone_number": "505-609-2258",
"fax_number": "505-609-2259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 S SCHWARTZ AVE",
"address_2": "STE 102",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "87401",
"telephone_number": "505-609-6700",
"fax_number": "505-609-6701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "BRENDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2013-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NM",
"license": "2003-0194",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "37320777",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
- Aderemi A. Jaiyeola
- Priscilla A Jake
- Elizabeth Ruth Jakeway
- James R Cole D.D.S.,PC
- James R Cole D.D.S.,PC
- Jerrald Tom James
- Marquita James
- Michelle James
- Shardai James
- Savanna Dru Jamison
All providers in Farmington, NM · Pediatrics Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 27, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.