Individual provider Active NPI

Amy Davis, CNP

  • Surgery Physician
  • Albuquerque, NM
National Provider Identifier
1841384237
Registry record updated Aug 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
R19892 Issued in NM
Practice address
PMG Pediatric Surgical Group
201 Cedar SE Suite 503
Albuquerque, NM 87106
Phone
(505) 224-7478
Fax
(505) 224-7479
NPI assigned
Oct 3, 2006
Last updated
Aug 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X R19892 NM Primary

Addresses

Primary practice location

PMG Pediatric Surgical Group
201 Cedar SE Suite 503
Albuquerque, NM 87106

Mailing address

PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 1

IdentifierTypeStateIssuer
7036205MedicaidNM

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

NPI Registry JSON

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": "1841384237",
    "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 PEDIATRIC SURGICAL GROUP",
            "address_2": "201 CEDAR SE SUITE 503",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87106",
            "telephone_number": "505-224-7478",
            "fax_number": "505-224-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "AMY",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "R19892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7036205",
            "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 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.