Active NPI
Shalon Drags Wolf
- Specialist
- Albuquerque, NM
National Provider Identifier
1821706458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 11005 Spain Rd NE Ste 15
Albuquerque, NM 87111-1871 - Phone
- (505) 850-4921
- NPI assigned
- Nov 14, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
11005 Spain Rd NE Ste 15
Albuquerque, NM 87111-1871
Mailing address
PO Box 12898
Albuquerque, NM 87195-0898
Phone (505) 850-4921
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668384000000",
"number": "1821706458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 12898",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871950898",
"telephone_number": "505-850-4921",
"fax_number": "505-859-4214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11005 SPAIN RD NE STE 15",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871111871",
"telephone_number": "505-850-4921"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRAGS WOLF",
"first_name": "SHALON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-11-14",
"last_updated": "2022-11-14",
"certification_date": "2022-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.