Individual provider Active NPI

Susan Vitali Gloyd, M.D.

  • Internal Medicine Physician
  • Albuquerque, NM
National Provider Identifier
1730241464
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
95-245 Issued in NM
Practice address
8308 Anaheim Ave NE
Albuquerque, NM 87122-2853
Phone
(505) 858-0413
Fax
(505) 858-0413
NPI assigned
Dec 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 95-245 NM Primary

Addresses

Primary practice location

8308 Anaheim Ave NE
Albuquerque, NM 87122-2853

Mailing address

8308 Anaheim Ave NE
Albuquerque, NM 87122-2853
Phone (505) 858-0413

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
95-245NMMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730241464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8308 ANAHEIM AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222853",
            "telephone_number": "505-858-0413",
            "fax_number": "505-858-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8308 ANAHEIM AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871222853",
            "telephone_number": "505-858-0413",
            "fax_number": "505-858-0413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOYD",
        "first_name": "SUSAN",
        "middle_name": "VITALI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "95-245",
            "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 Jul 8, 2007; 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.