Functional Family Medicine

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

Legal business name

FUNCTIONAL FAMILY MEDICINE

Practice address

7301 Jefferson St NE Ste G
Albuquerque, NM 87109-4363

Phone

(505) 225-4044

Fax

(505) 508-5284

NPI assigned

Sep 2, 2014

Organization subpart

No

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

Authorized official

Name

Camille JohnsonNPI 1508902412

Title

Owner

Phone

(505) 550-1183

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Camille Rose Johnson, CFNP

  • Family Nurse Practitioner
  • Albuquerque, NM
  • NPI 1508902412
  NPD (past) Authorized official
• Matthew J Moody, FNP

  • Family Nurse Practitioner
  • Albuquerque, NM
  • NPI 1851097208
  NPD (past)

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409616000000",
    "number": "1932509403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7301 JEFFERSON ST NE STE G",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094363",
            "telephone_number": "505-225-4044",
            "fax_number": "505-508-5284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 JEFFERSON ST NE STE G",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094363",
            "telephone_number": "505-225-4044",
            "fax_number": "505-508-5284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-550-1183"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Lee Fullmer, LMT
• Adam Fulton, CSW
• Pamela Angel Fulton, NP
• Shawn Lee Fultz, M.D., J.D., M.P.H.
• Functional Aquatics Therapy
• Functional Movement LLC
• Functional Orthotics & Prosthetics
• Functional Playground Therapies LLC
• Fundamental Therapy Services LLC
• Erik J. Funk, MD

• Family Health Clinical Nurse Specialist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Family Health Clinical Nurse Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.