Active NPI
Stephanie Fallon, MD
- Psychiatry Physician
- Albuquerque, NM
National Provider Identifier
1942216528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 90-190
- Practice address
- 2100 Ridgecrest Dr SE
VA Medical Center
Albuquerque, NM 87108-5128 - Phone
- (505) 265-1711
- NPI assigned
- Aug 1, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 90-190 | NM | Primary |
Addresses
Primary practice location
2100 Ridgecrest Dr SE
VA Medical Center
Albuquerque, NM 87108-5128
Mailing address
2100 Ridgecrest Dr SE
Msc09 5030
Albuquerque, NM 87108-5128
Phone (505) 265-1711
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90-190 | NM | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942216528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 RIDGECREST DR SE",
"address_2": "MSC09 5030",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871085128",
"telephone_number": "505-265-1711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 RIDGECREST DR SE",
"address_2": "VA MEDICAL CENTER",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871085128",
"telephone_number": "505-265-1711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALLON",
"first_name": "STEPHANIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NM",
"license": "90-190",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.