NPIMap

Organization Active NPI

Express Transportation of New Mexico, LLC

  • Non-emergency Medical Transport (VAN)
  • Albuquerque, NM
National Provider Identifier
1881901379
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
79172385 Issued in NM
Legal business name
EXPRESS TRANSPORTATION OF NEW MEXICO, LLC
Practice address
2123 Menaul Blvd NE
Suite B
Albuquerque, NM 87107-1745
Phone
(505) 881-7433
Fax
(505) 888-8877
NPI assigned
Sep 7, 2010
Last updated
Sep 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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

Authorized official

Name
Mr. Dave Devereaux
Title
Co-Owner
Phone
(505) 881-7433

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 79172385 NM Primary

Addresses

Primary practice location

2123 Menaul Blvd NE
Suite B
Albuquerque, NM 87107-1745

Mailing address

2123 Menaul Blvd NE
Suite B
Albuquerque, NM 87107-1745
Phone (505) 881-7433

Other identifiers 1

IdentifierTypeStateIssuer
79172385MedicaidNM

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283817600000",
    "number": "1881901379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2123 MENAUL BLVD NE",
            "address_2": "SUITE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871071745",
            "telephone_number": "505-881-7433",
            "fax_number": "505-888-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2123 MENAUL BLVD NE",
            "address_2": "SUITE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871071745",
            "telephone_number": "505-881-7433",
            "fax_number": "505-888-8877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPRESS TRANSPORTATION OF NEW MEXICO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A",
        "authorized_official_last_name": "DEVEREAUX",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "505-881-7433",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NM",
            "license": "79172385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "79172385",
            "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 Sep 7, 2010; 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.