Individual provider Active NPI

Cheryl Renee Brubaker, DNP, FNP-BC

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1982712048
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP00258 Issued in NM
Practice address
3217 Cardenas Dr NE
Albuquerque, NM 87110-2540
Phone
(505) 280-6246
NPI assigned
Aug 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X CNP00258 NM Primary
Registered Nurse 163W00000X R18198 NM

Addresses

Primary practice location

3217 Cardenas Dr NE
Albuquerque, NM 87110-2540

Mailing address

3217 Cardenas Dr NE
Albuquerque, NM 87110-2540
Phone (505) 280-6246

Other identifiers 2

IdentifierTypeStateIssuer
46830383MedicaidNM
NM006A84OtherNMBCBS OF NM

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R18198NMMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1982712048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 CARDENAS DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871102540",
            "telephone_number": "505-280-6246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 CARDENAS DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871102540",
            "telephone_number": "505-280-6246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "CHERYL",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP00258",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R18198",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "46830383",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NM",
            "identifier": "NM006A84",
            "state": "NM"
        }
    ],
    "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 21, 2015; 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.