Active NPI
Daniel Paz-Rudolph, ATC, LAT, CKTT
- Athletic Trainer
- Albuquerque, NM
National Provider Identifier
1871983015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 608
- Practice address
- 4700 Coal Ave SE
Albuquerque, NM 87108-2804 - Phone
- (505) 265-3711
- NPI assigned
- Jan 26, 2015
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 608 | NM | Primary |
Addresses
Primary practice location
4700 Coal Ave SE
Albuquerque, NM 87108-2804
Mailing address
2704 Los Anayas Rd NW
Albuquerque, NM 87104-2934
Phone (505) 363-3378
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
| License | State | Type | Specialty |
|---|---|---|---|
| 608 | NM | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1422230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422230400000",
"number": "1871983015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2704 LOS ANAYAS RD NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871042934",
"telephone_number": "505-363-3378"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4700 COAL AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871082804",
"telephone_number": "505-265-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAZ-RUDOLPH",
"first_name": "DANIEL",
"credential": "ATC, LAT, CKTT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-01-26",
"last_updated": "2015-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NM",
"license": "608",
"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 Jan 26, 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.