Active NPI
Carol Nelson, M.D.
- Psychiatry Physician
- Albuquerque, NM
National Provider Identifier
1740395813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD2009-0640
- Practice address
- 1325 Wyoming Blvd NE
Albuquerque, NM 87112-5046 - Phone
- (505) 291-5300
- NPI assigned
- Aug 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD2009-0640 | NM | Primary |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD2009-0640 | NM |
Addresses
Primary practice location
1325 Wyoming Blvd NE
Albuquerque, NM 87112-5046
Mailing address
1325 Wyoming Blvd NE
Albuquerque, NM 87112-5046
Phone (505) 291-5300
Other names 1
- Carol Boettger
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": "1156032000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366070400000",
"number": "1740395813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1325 WYOMING BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871125046",
"telephone_number": "505-291-5300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1325 WYOMING BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871125046",
"telephone_number": "505-291-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "CAROL",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-20",
"last_updated": "2013-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NM",
"license": "MD2009-0640",
"primary": true
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "NM",
"license": "MD2009-0640",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROL",
"last_name": "BOETTGER",
"code": "1",
"type": "Former Name"
}
]
}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 Apr 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.