NPIMap

Organization Active NPI

Northside Family Medicine PC

  • Family Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1720096852
Registry record updated Aug 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A91890 Issued in NM
Legal business name
NORTHSIDE FAMILY MEDICINE PC
Practice address
6100 Pan American Freeway, NE
Suite 390
Albuquerque, NM 87109-3401
Phone
(505) 823-1805
Fax
(505) 823-1844
NPI assigned
Aug 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2014

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

Authorized official

Name
Margaret W Royson, DO
Title
Owner
Phone
(505) 823-1805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A91890 NM Primary

Addresses

Primary practice location

6100 Pan American Freeway, NE
Suite 390
Albuquerque, NM 87109-3401

Mailing address

6100 Pan American Freeway, NE
Suite 390
Albuquerque, NM 87109-3401
Phone (505) 823-1805

Other identifiers 1

IdentifierTypeStateIssuer
F8984MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408492800000",
    "number": "1720096852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6100 PAN AMERICAN FREEWAY, NE",
            "address_2": "SUITE 390",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093401",
            "telephone_number": "505-823-1805",
            "fax_number": "505-823-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 PAN AMERICAN FREEWAY, NE",
            "address_2": "SUITE 390",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093401",
            "telephone_number": "505-823-1805",
            "fax_number": "505-823-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSIDE FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2014-08-20",
        "status": "A",
        "authorized_official_last_name": "ROYSON",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-823-1805",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A91890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F8984",
            "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 Aug 20, 2014; 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.