Edward L Childers, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A65376 Issued in NM

Practice address

3825 Eubank Blvd NE
Ste C
Albuquerque, NM 87111-3575

Phone

(505) 298-8020

Fax

(505) 292-5006

NPI assigned

Sep 1, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2015 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1125532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1679567986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 EUBANK BLVD NE",
            "address_2": "STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113575",
            "telephone_number": "505-298-8020",
            "fax_number": "505-292-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 EUBANK BLVD NE",
            "address_2": "STE C",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113575",
            "telephone_number": "505-298-8020",
            "fax_number": "505-292-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "EDWARD",
        "middle_name": "L",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-01",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A65376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Becky Dinh Chiem, D.D.S
• Kanayo Chiemelu
• Jack Chien, DO
• Child Psychological Services of New Mexico, LLC
• Kacee Child
• Childhood Is Calling, LLC
• Children'S Community Mental Health Clinic
• Children'S Treatment Center
• Childrens Psychiatric Center Outpatient Services
• Demetra Childress, MS

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.