NPIMap

Organization Active NPI

FNCH SBHC Naca High School

  • Student Health Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1740784198
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
FNCH SBHC NACA HIGH SCHOOL
Practice address
1711 Stanford Dr NE
Albuquerque, NM 87106-2535
Phone
(505) 262-2481
Fax
(505) 265-7045
NPI assigned
Mar 21, 2018
Organization subpart
Yes
Parent organization
FIRST NATIONS COMMUNITY HEALTH SOURCE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Authorized official

Name
Juanita J Widener
Title
Billing Manager
Phone
(505) 262-6588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

1711 Stanford Dr NE
Albuquerque, NM 87106-2535

Mailing address

5608 Zuni Rd SE
Albuquerque, NM 87108-2926
Phone (505) 262-6588

Other identifiers 1

IdentifierTypeStateIssuer
00046912MedicaidNM

National Provider Directory

National Provider Directory
Tax ID family
First Nations Community Healthsource Inc13 organizations share this tax ID, including this one
Part of
First Nations Community Healthsource Inc

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1521590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728345600000",
    "number": "1740784198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5608 ZUNI RD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082926",
            "telephone_number": "505-262-6588",
            "fax_number": "505-262-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 STANFORD DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871062535",
            "telephone_number": "505-262-2481",
            "fax_number": "505-265-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FNCH SBHC NACA HIGH SCHOOL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIRST NATIONS COMMUNITY HEALTH SOURCE, INC.",
        "enumeration_date": "2018-03-21",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A",
        "authorized_official_last_name": "WIDENER",
        "authorized_official_first_name": "JUANITA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "505-262-6588"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00046912",
            "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 Oct 8, 2024; 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.