Provider Cares Network LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PROVIDER CARES NETWORK LLC

Practice address

10401 Montgomery Pkwy NE Ste 1a
Albuquerque, NM 87111-3876

Phone

(323) 805-9987

NPI assigned

Jul 23, 2020

Last updated

Jul 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jerone Moeoge

Title

Managing Member

Phone

(323) 805-9987

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1710596036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 MONTGOMERY PKWY NE STE 1A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 MONTGOMERY PKWY NE STE 1A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113876",
            "telephone_number": "323-805-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDER CARES NETWORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "MOEOGE",
        "authorized_official_first_name": "JERONE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "323-805-9987"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.