ADVANCED DIABETES CARE, LLC. (NPI# 1366744229) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366744229 |
| Entity Type | Organization |
| Organization Name | ADVANCED DIABETES CARE, LLC. |
| Practice Address |
3901 Georgia St Ne Ste B1 Albuquerque NM 87110-1390 |
| Practice Telephone | 5058814648 |
| Practice Fax Number | 5058814694 |
| Mailing Telephone | 5058814648 |
| Mailing Fax Number | 5058814694 |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2018-04-03 |
| Authorized Official Name | JULIE D KRAWCHUCK (OWNER/CFNP) |
| Authorized Official Telephone | 5058814648 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 21682364 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4215 Montgomery Blvd Ne, Building C, Albuquerque, NM 871091103 | 5058814648 | 5058814694 |
| Street Address |
3901 GEORGIA ST NE STE B1 |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87110-1390 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215550199 | Sabrina Jennifer Lujan | Counselor | 8401 Constitution Ave Nw, Albuquerque, NM 87110 | 2020-05-26 |
| 1649829318 | Robert D. Oliver | Technician | 2705 Texas Street Ne, Albuquerque, NM 87110 | 2019-09-05 |
| 1033770904 | Life Re-created LLC | Counselor | 3939 San Pedro Dr. Ne, Bld C, Ste 8, Albuquerque, NM 87110 | 2019-06-21 |
| 1497319693 | Clear Choice Vision Care, LLC | Optometrist | 6600 Menaul Blve Ne, Suite M5a, Albuquerque, NM 87110 | 2019-04-24 |
| 1790257558 | Diana M Nicolas | Dietitian, Registered | 8300 Constitution Ave Ne Bld D, Albuquerque, NM 87110 | 2018-12-18 |
| 1689168403 | Robin N Hermes, Md, PC | Anesthesiology | 2440 Lousiana Blvd. Ne, Ste 580, Albuquerque, NM 87110 | 2018-06-15 |
| 1710481726 | Desert Mountain Eyecare LLC | Optometrist | 5504 Menaul Blvd Ne Ste Aandb, Albuquerque, NM 87110 | 2018-03-23 |
| 1659873131 | Amanda Lacasse | Registered Nurse | 6400 Uptown Blvd Ne Suite 360 West, Albuquerque, NM 87110 | 2018-03-01 |
| 1518485655 | Danielle Liegh Wyne | Counselor | 6121 Indian School Rd, Suite 141, Albuquerque, NM 87110 | 2017-09-08 |
| 1265957237 | Myrrhine Faller | Speech-Language Pathologist | 6020 Constitution Ave. Ne, Suite 4, Albuquerque, NM 87110 | 2017-08-10 |
| Find all providers in zip 87110 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720606882 | Mountain Desert Health LLC | Nurse Practitioner | 2200 Panola St Sw, Albuquerque, NM 87121-2582 | 2020-07-06 |
| 1912538844 | Lorine Derusha | Nurse Practitioner | 625 Silver Ave Sw Fl 2, Albuquerque, NM 87102-3123 | 2020-01-29 |
| 1295374247 | Thomas William Cox | Nurse Practitioner | 12812 Constitution Ave Ne Apt 2, Albuquerque, NM 87112-6142 | 2019-12-21 |
| 1730720632 | Carmen Caterina Marcolina | Nurse Practitioner | 4201 Central Ave Nw # 3, Albuquerque, NM 87105-1630 | 2019-10-01 |
| 1700349834 | Heather Marie Pink | Nurse Practitioner | 7802b Ironwood Ct Se, Albuquerque, NM 87116-1135 | 2019-04-06 |
| 1467936187 | New Mexico Health Care Clinicians LLC | Nurse Practitioner | 3911 4th St Nw Ste A, Albuquerque, NM 87107-2510 | 2018-09-18 |
| 1609354398 | Marisa Escobar | Nurse Practitioner | 3613 State Hwy 528 Nw, Albuquerque, NM 87114-8918 | 2018-08-03 |
| 1154807725 | Andrea Chavez-benavidez | Nurse Practitioner | 6201 Jefferson St Ne Ste 103, Albuquerque, NM 87109-3431 | 2018-07-17 |
| 1356842488 | Jopaul Valles | Nurse Practitioner | 407 Solano Dr Ne, Albuquerque, NM 87108-1045 | 2018-02-23 |
| 1275045700 | Janna Rorebeck | Nurse Practitioner | 6804 Calle Santiago Ne, Albuquerque, NM 87113-1217 | 2017-10-24 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87110 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.