Douglas Ivan Ludington, NP
Individual provider Active NPI Family Nurse Practitioner · Edgewood, NM
NPI 1982113445 · NPPES record last updated May 9, 2019
Key facts
- NPI
- 1982113445
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- CNP-03395 (NM)
- Practice address
- 104 Quail Trail
Unit B
Edgewood, NM 87015 - Phone
- (505) 208-0204
- NPI assigned
- Sep 27, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- McLeod Medical Centers of NM Inc
Practice addresses (Care Compare)
1108 US Route 66 W
Moriarty, NM 87035-1006
Phone (505) 281-5180
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NM, UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171101000736 | NM | Practitioner - Nurse Practitioner | 8426324773 | Reassigns benefits to 2 organizations |
| I20250414003018 | UT | Practitioner - Nurse Practitioner | 8426324773 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNP-03395 | NM | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ludington Primary Care LLC | Current |
Accepting new patients | |
| McLeod Medical Centers of NM, Inc. | Current |
Accepting new patients | |
| McLeod Medical Centers of NM, Inc. | Current |
Accepting new patients | |
| Albuquerque Urgent Care Walk in Clinic PC | Current |
Accepting new patients | |
| Skycloud Psychiatry LLC | Past | Accepting new patients |
Locations
1901 Juan Tabo Blvd NE
Albuquerque, NM 87112
Phone (505) 262-9200
4410 Irving Blvd NW
Albuquerque, NM 87114
Phone (505) 768-6123
5850 Eubank Blvd NE
Ste B32
Albuquerque, NM 87111
Phone (505) 200-2860
7200 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 814-1995
11501 Montgomery Blvd NE
Albuquerque, NM 87111
Phone (505) 814-1333
12127 N State Highway 14
Ste 5
Cedar Crest, NM 87008
Phone (505) 281-2460
1851 Old US 66
Edgewood, NM 87015
Phone (505) 281-8463
1202 Main St NE
Ste A
Los Lunas, NM 87031
Phone (505) 565-0070
Interoperability endpoints
- douglas.ludington.1@27050.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | CNP-03395 | NM | Yes |
Addresses
Primary practice location
104 Quail Trail
Unit B
Edgewood, NM 87015
Mailing address
12127B Hwy 14 N
Ste 5
Cedar Crest, NM 87008-9499
Phone (505) 281-5180
Other practice location 1
104 Quail Trail
Unit B
Edgewood, NM 87015
Phone (505) 208-0204
Other practice location 2
5850 Eubank Blvd NE Ste B32
Albuquerque, NM 87111
Phone (505) 200-2860
Other providers in Edgewood, NM
- Sharon A Lamoree-Lukasavage
- Amber Lampiris-Tremba
- Julie Suzanne Lindberg
- Deborah Ann Lucas
- Lindsey Lucero
- Caroline Ludwig
- Judy H. Lui
- Frank Paul Lukasavage
- Gavin Lynch
- Bebe Makena
All providers in Edgewood, NM · Family Nurse Practitioner in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.