Active NPI
Neurodiagnostics LTD.
- Neurology Physician
- Farmington, NM
National Provider Identifier
1942365416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 2000-14
- Legal business name
- NEURODIAGNOSTICS LTD.
- Practice address
- 4801 N Butler Ave
Ste. 8102
Farmington, NM 87401-0818 - Phone
- (505) 326-7153
- Fax
- (505) 326-7767
- NPI assigned
- Dec 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Denise Breeden
- Title
- Office Manager
- Phone
- (505) 326-7153
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 2000-14 | NM | Primary |
Addresses
Primary practice location
4801 N Butler Ave
Ste. 8102
Farmington, NM 87401-0818
Mailing address
4801 N Butler Ave
Ste. 8102
Farmington, NM 87401-0818
Phone (505) 326-7153
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 69631 | Medicaid | NM |
National Provider Directory
National Provider DirectoryLocations
4800 College Blvd
Ste 102
Farmington, NM 87402
Phone (505) 326-1753
4801 N Butler Ave
Ste 8102
Farmington, NM 87401
Phone (505) 326-7153
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Neurology Physician
- Olympia, WA
- NPI 1336160373
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1198195200000",
"number": "1942365416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 N BUTLER AVE",
"address_2": "STE. 8102",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874010818",
"telephone_number": "505-326-7153",
"fax_number": "505-326-7767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 N BUTLER AVE",
"address_2": "STE. 8102",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874010818",
"telephone_number": "505-326-7153",
"fax_number": "505-326-7767"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEURODIAGNOSTICS LTD.",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-26",
"last_updated": "2007-12-21",
"status": "A",
"authorized_official_last_name": "BREEDEN",
"authorized_official_first_name": "DENISE",
"authorized_official_title_or_position": "OFFICE MANAGER",
"authorized_official_telephone_number": "505-326-7153"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NM",
"license": "2000-14",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "69631",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.