Active NPI
Richard P Stam, MD
- Pediatrics Physician
- Albuquerque, NM
National Provider Identifier
1871724476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 69-195
- Practice address
- 1100 Central SE
PMG Urgent Care
Albuquerque, NM 87106 - Phone
- (505) 841-1819
- Fax
- (505) 724-7673
- NPI assigned
- Jul 30, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 69-195 | NM | Primary |
Addresses
Primary practice location
1100 Central SE
PMG Urgent Care
Albuquerque, NM 87106
Mailing address
PO Box 26666
PHS Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5364
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69-195 | NM | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248912000000",
"number": "1871724476",
"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": "505-923-5364",
"fax_number": "505-923-5354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 CENTRAL SE",
"address_2": "PMG URGENT CARE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "87106",
"telephone_number": "505-841-1819",
"fax_number": "505-724-7673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAM",
"first_name": "RICHARD",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-30",
"last_updated": "2009-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NM",
"license": "69-195",
"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 Jul 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.