Individual provider Active NPI

Michael Konkol, PHARM. D

  • Pharmacist
  • Albuquerque, NM
National Provider Identifier
1992179477
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RP00008469 Issued in NM
Practice address
8100 Ventura St NE
Albuquerque, NM 87122-1303
Phone
(505) 822-8484
NPI assigned
Nov 19, 2015
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP00008469 NM Primary

Addresses

Primary practice location

8100 Ventura St NE
Albuquerque, NM 87122-1303

Mailing address

8100 Ventura St NE
Albuquerque, NM 87122-1303
Phone (505) 822-8484

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 Pharmacy

State licenses

LicenseStateTypeSpecialty
RP00008469NMMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1447891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1992179477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 VENTURA ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871221303",
            "telephone_number": "505-822-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 VENTURA ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871221303",
            "telephone_number": "505-822-8484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONKOL",
        "first_name": "MICHAEL",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-19",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "RP00008469",
            "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 Mar 4, 2024; 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.