NPIMap

Organization Active NPI

Petroglyph Pathology Services, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Rio Rancho, NM
National Provider Identifier
1801003231
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
PETROGLYPH PATHOLOGY SERVICES, LLC
Practice address
640 Quantum Rd NE
Rio Rancho, NM 87124-4506
Phone
(505) 924-0209
Fax
(505) 924-0210
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

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

Authorized official

Name
Ms. Sandra M Mueller, M.D.
Title
Pathologist
Phone
(505) 924-0209

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

640 Quantum Rd NE
Rio Rancho, NM 87124-4506

Mailing address

640 Quantum Rd NE
Rio Rancho, NM 87124-4506
Phone (505) 924-0209

National Provider Directory

National Provider Directory

Locations

640 Quantum Rd NE
Rio Rancho, NM 87124
Phone (505) 924-0209

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412208000000",
    "number": "1801003231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 QUANTUM RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244506",
            "telephone_number": "505-924-0209",
            "fax_number": "505-924-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 QUANTUM RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244506",
            "telephone_number": "505-924-0209",
            "fax_number": "505-924-0210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETROGLYPH PATHOLOGY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2014-10-02",
        "status": "A",
        "authorized_official_last_name": "MUELLER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PATHOLOGIST",
        "authorized_official_telephone_number": "505-924-0209",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; 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.