Organization Active NPI

Turquoise Mesa LLC

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1699161216
Registry record updated Mar 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP02306 Issued in NM
Legal business name
TURQUOISE MESA LLC
Practice address
4201 Central Ave NW
Suite K-2
Albuquerque, NM 87105-1630
Phone
(505) 503-7250
Fax
(505) 554-2313
NPI assigned
Apr 9, 2015
Last updated
Mar 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2016

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

Authorized official

Name
Julianne Austin, CNPNPI 1124374004
Title
Member/Nurse Practitioner
Phone
(352) 250-5350

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP02306 NM Primary

Addresses

Primary practice location

4201 Central Ave NW
Suite K-2
Albuquerque, NM 87105-1630

Mailing address

4201 Central Ave NW
Suite K-2
Albuquerque, NM 87105-1630
Phone (505) 503-7250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150723006963 NM Part B Supplier - Clinic/Group Practice 4688987498 Receives reassigned benefits from 1 practitioner
Practice locations: Moriarty, NM

National Provider Directory

National Provider Directory

Locations

3150 Carlisle Blvd NE
Ste 107
Albuquerque, NM 87110
Phone (505) 830-6044

4201 Central Ave NW
Ste K2
Albuquerque, NM 87105
Phone (505) 503-7250

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457913600000",
    "number": "1699161216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 CENTRAL AVE NW",
            "address_2": "SUITE K-2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871051630",
            "telephone_number": "505-503-7250",
            "fax_number": "505-554-2313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 CENTRAL AVE NW",
            "address_2": "SUITE K-2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871051630",
            "telephone_number": "505-503-7250",
            "fax_number": "505-554-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TURQUOISE MESA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-09",
        "last_updated": "2016-03-14",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "JULIANNE",
        "authorized_official_title_or_position": "MEMBER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "352-250-5350",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP02306",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.