NPIMap

Organization Active NPI

Amerigroup Community Care of New Mexico, Inc.

  • Health Maintenance Organization
  • Albuquerque, NM
National Provider Identifier
1922287580
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
5019 Issued in NM
Legal business name
AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.
Practice address
2 Park SQ
6565 Americas Parkway, NE, Suite 200
Albuquerque, NM 87110-5374
Phone
(505) 563-5554
NPI assigned
Oct 31, 2007
Last updated
Jan 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Authorized official

Name
Marc Russo
Title
President
Phone
(212) 518-5250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 5019 NM Primary

Addresses

Primary practice location

2 Park SQ
6565 Americas Parkway, NE, Suite 200
Albuquerque, NM 87110-5374

Mailing address

2 Park SQ
6565 Americas Parkway, NE, Suite 200
Albuquerque, NM 87110-5374
Phone (505) 563-5554

Other names 1

  • AMERIGROUP New Mexico, Inc. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389052800000",
    "number": "1922287580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 PARK SQ",
            "address_2": "6565 AMERICAS PARKWAY, NE, SUITE 200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105374",
            "telephone_number": "505-563-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PARK SQ",
            "address_2": "6565 AMERICAS PARKWAY, NE, SUITE 200",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105374",
            "telephone_number": "505-563-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2014-01-07",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-518-5250"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NM",
            "license": "5019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMERIGROUP New Mexico, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 7, 2014; 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.