Active NPI
Kathy Jean O'Connor, MD
- Internal Medicine Physician
- Albuquerque, NM
National Provider Identifier
1679584684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD2014-0587
- Practice address
- 5150 Journal Center Blvd NE FL 2
Albuquerque, NM 87109-5900 - Phone
- (505) 262-3212
- Fax
- (505) 232-1532
- NPI assigned
- Aug 11, 2006
- Last updated
- Sep 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 27775 | AZ | |
| Internal Medicine Physician | 207R00000X | MD2014-0587 | NM | Primary |
Addresses
Primary practice location
5150 Journal Center Blvd NE FL 2
Albuquerque, NM 87109-5900
Mailing address
PO Box 26028
Albuquerque, NM 87125-6028
Phone (505) 262-3212
Other practice location 1
8675 Rio Grande Blvd NW
Los Ranchos, NM 87114-1301
Phone (928) 300-7576
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 90558235 | Medicaid | NM | |
| 480088 | Medicaid | AZ | |
| 804682 | Other | NM | CMS |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568160000000",
"number": "1679584684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26028",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871256028",
"telephone_number": "505-262-3212",
"fax_number": "505-232-1532"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 JOURNAL CENTER BLVD NE FL 2",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871095900",
"telephone_number": "505-262-3212",
"fax_number": "505-232-1532"
}
],
"practiceLocations": [
{
"address_1": "8675 Rio Grande Blvd NW",
"address_purpose": "LOCATION",
"city": "Los Ranchos",
"state": "NM",
"postal_code": "871141301",
"country_code": "US",
"telephone_number": "928-300-7576",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "O'CONNOR",
"first_name": "KATHY",
"middle_name": "JEAN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2019-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "AZ",
"license": "27775",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NM",
"license": "MD2014-0587",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "90558235",
"state": "NM"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "480088",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CMS",
"identifier": "804682",
"state": "NM"
}
],
"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 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.