Active NPI
Charles Fred Newberry III, DOM
- Acupuncturist
- Santa Fe, NM
National Provider Identifier
1912499328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 1225
- Practice address
- 1446 S Saint Francis Dr
Santa Fe, NM 87505-4038 - Phone
- (505) 690-2178
- NPI assigned
- May 31, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1225 | NM | Primary |
Addresses
Primary practice location
1446 S Saint Francis Dr
Santa Fe, NM 87505-4038
Mailing address
332 1/2 Camino Cerrito
Santa Fe, NM 87505-5912
Phone (505) 216-0864
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 |
|---|---|---|---|
| 1225 | NM | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1912499328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "332 1/2 CAMINO CERRITO",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875055912",
"telephone_number": "505-216-0864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1446 S SAINT FRANCIS DR",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054038",
"telephone_number": "505-690-2178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWBERRY",
"first_name": "CHARLES",
"middle_name": "FRED",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "DOM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-05-31",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "NM",
"license": "1225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.