Randall G Brewer, PA-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

PA-6818 Issued in NM

Practice address

PMG Atrisco
3901 Atrisco NW
Albuquerque, NM 87120

Phone

(505) 462-7575

Fax

(505) 462-7555

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219104000000",
    "number": "1770677148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PMG ATRISCO",
            "address_2": "3901 ATRISCO NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87120",
            "telephone_number": "505-462-7575",
            "fax_number": "505-462-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "RANDALL",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "PA-6818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95375",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juliette Elisabeth Brewer-Smith, PHC, PHARM.D.
• Brittany Brewer
• Jennifer Brewer
• Lauren Brewer
• Megan E Brewer, SLP CFY
• Richard Brewer, MD
• Torri Brewer
• Tyler Brewer, MS CCC-SLP
• Stephanie Brewster
• Judith Anne Brey, M.A.

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2008; 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.