Theresa Ann Bubenzer, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP-01998 Issued in NM

Practice address

3917 West Rd Ste a
Los Alamos, NM 87544-2292

Phone

(505) 661-8900

Fax

(505) 661-8916

NPI assigned

Mar 1, 2007

Last updated

Sep 23, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Artesia General Hospital

  dba Artesia Healthcare Professionals

  • Surgery Physician
  • Artesia, NM
  • NPI 1114076825

  Family

  NPD (past)
• Southside Emergency Associates

  • Personal Emergency Response Attendant
  • Indianapolis, IN
  • NPI 1053366922
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1811025703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3917 WEST RD STE A",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442292",
            "telephone_number": "505-661-8900",
            "fax_number": "505-661-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD STE A",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442292",
            "telephone_number": "505-661-8900",
            "fax_number": "505-661-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUBENZER",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-01998",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002349A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "RN-75785",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CNP-01998",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "71002349A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ross Edward Bridge, MD
• Curtis Aseal Brookover, DDS
• Jane Brooks
• Katherine Lynn Brousseau
• Nancy Brugh
• Lauren Bucklin
• Sara Elise Bulthuis
• Camryn Bussell
• Tatiana Canning
• Reed F Cannon, DMD

• Nurse Practitioner in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.