Individual provider Active NPI

Andrea M Mulford

  • Specialist
  • Albuquerque, NM
National Provider Identifier
1841465788
Registry record updated Apr 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
0616920001 Issued in NM
Practice address
1524 Eubank Blvd NE Ste 1
Albuquerque, NM 87112-4160
Phone
(505) 292-2508
Fax
(505) 292-2509
NPI assigned
Apr 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0616920001 NM Primary

Addresses

Primary practice location

1524 Eubank Blvd NE Ste 1
Albuquerque, NM 87112-4160

Mailing address

1524 Eubank Blvd NE Ste 1
Albuquerque, NM 87112-4160
Phone (505) 292-2508

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

State licenses

LicenseStateTypeSpecialty
0616920001NMMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico CPM Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1841465788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 EUBANK BLVD NE STE 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871124160",
            "telephone_number": "505-292-2508",
            "fax_number": "505-292-2509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 EUBANK BLVD NE STE 1",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871124160",
            "telephone_number": "505-292-2508",
            "fax_number": "505-292-2509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULFORD",
        "first_name": "ANDREA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "0616920001",
            "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 Apr 22, 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.