Individual provider Active NPI

Camille Ross Coffey, DC

  • Chiropractor
  • Tijeras, NM
National Provider Identifier
1679439400
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-2025-033 Issued in NM
Practice address
11 Moss Rose LN
Tijeras, NM 87059-7946
Phone
(505) 503-0190
NPI assigned
Dec 24, 2025
Last updated
Dec 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-2025-033 NM Primary

Addresses

Primary practice location

11 Moss Rose LN
Tijeras, NM 87059-7946

Mailing address

11 Moss Rose LN
Tijeras, NM 87059-7946

Other practice location 1

1942 Old US 66 Ste B
Edgewood, NM 87015-6745
Phone (505) 715-4705

Other practice location 2

4127 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Phone (505) 308-8885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DC-2025-033NMMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Chiropractic, PC Chiropractor PastSince Jul 7, 2024 Accepting new patients
Anderson Chiropractic, PC Chiropractor PastSince Aug 4, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1766534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766534400000",
    "number": "1679439400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 MOSS ROSE LN",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870597946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 MOSS ROSE LN",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870597946",
            "telephone_number": "505-503-0190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1942 Old US 66 Ste B",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "NM",
            "postal_code": "870156745",
            "country_code": "US",
            "telephone_number": "505-715-4705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4127 Montgomery Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871091102",
            "country_code": "US",
            "telephone_number": "505-308-8885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "CAMILLE",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-24",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "DC-2025-033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tijeras, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2025; 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.