NPIMap

Organization Active NPI

Heart Brain International, LLC

  • Professional Counselor
  • Albuquerque, NM
National Provider Identifier
1760850416
Registry record updated Sep 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
102651 Issued in NM
Legal business name
HEART BRAIN INTERNATIONAL, LLC
Practice address
3228 Los Arboles Ave NE # a-200
Albuquerque, NM 87107-1962
Phone
(505) 933-5301
NPI assigned
Sep 11, 2015
Last updated
Sep 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2015

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

Authorized official

Name
David Zimpelman, MBR
Title
Registered Agent
Phone
(505) 933-5301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 102651 NM Primary

Addresses

Primary practice location

3228 Los Arboles Ave NE # a-200
Albuquerque, NM 87107-1962

Mailing address

1312 Sierra Larga Dr. NE
Albuquerque, NM 87112
Phone (505) 933-5301

Other identifiers 2

IdentifierTypeStateIssuer
12554677OtherNMCAQH
96851287MedicaidNM

National Provider Directory

National Provider Directory

Locations

3228 Los Arboles Ave NE
#A200
Albuquerque, NM 87107
Phone (505) 933-5301

NPI Registry JSON

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442188800000",
    "number": "1760850416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 SIERRA LARGA DR. NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87112",
            "telephone_number": "505-933-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3228 LOS ARBOLES AVE NE # A-200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871071962",
            "telephone_number": "505-933-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART BRAIN INTERNATIONAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-14",
        "status": "A",
        "authorized_official_last_name": "ZIMPELMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "REGISTERED AGENT",
        "authorized_official_telephone_number": "505-933-5301",
        "authorized_official_credential": "MBR"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "102651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12554677",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96851287",
            "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 Sep 14, 2015; 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.