William Leonard Blevins, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

7390 Issued in NM

Practice address

101 Ocean Blvd
Mogul Medical Urgent Care
Taos Ski Valley, NM 87525-0067

Phone

(575) 776-8421

Fax

(575) 776-8942

NPI assigned

Apr 27, 2006

Reactivated

Jan 8, 2008

Last updated

Jan 10, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199923200000",
    "number": "1992762439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1108",
            "address_2": "45 CALLE DE CONEJO WILLIAM L BLEVINS MD",
            "city": "EL PRADO",
            "state": "NM",
            "postal_code": "875291108",
            "telephone_number": "575-776-8669",
            "fax_number": "575-776-8669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 OCEAN BLVD",
            "address_2": "MOGUL MEDICAL URGENT CARE",
            "city": "TAOS SKI VALLEY",
            "state": "NM",
            "postal_code": "875250067",
            "telephone_number": "575-776-8421",
            "fax_number": "575-776-8942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEVINS",
        "first_name": "WILLIAM",
        "middle_name": "LEONARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2008-01-10",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NM",
            "license": "7390",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M4320",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MT",
            "license": "6464",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "AK",
            "license": "2700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia L Gonzales, MD
• Timothy D Peterson, MD
• Kama Rickett, D.C.
• Timothy D Peterson, MD PC (Mogul Medical Urgent Care)

• Internal Medicine Physician in Taos Ski Valley, NM
• Providers in Taos Ski Valley, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.