DR. THOMAS SCOTT PANNKE (NPI# 1396779716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396779716 |
| Entity Type | Individual |
| Full Name | DR. THOMAS SCOTT PANNKE |
| Credential | M.D. |
| Practice Address |
601 Martin Luther King Ave Ne Albuquerque NM 87102-3619 |
| Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
| Practice Telephone | 5057278000 |
| Mailing Telephone | 8008939698 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2019-08-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | MD60793240 | WA | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 41606-020 | WI | Allopathic & Osteopathic Physicians |
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
9372-A | WY | Allopathic & Osteopathic Physicians |
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
MD2014-0522 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 31814700 | 05 | |
| WI | MEDICARE RAILROAD | 930106591 | 01 |
| WI | MEDICARE RAILROAD | 930078269 | 01 |
| WI | MEDICARE RAILROAD | 930079986 | 01 |
| MI | 104160666 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1016 Tacoma Ave, Sunnyside, WA 989442263 | 5098371500 | 5098371380 |
| 110 S 9th Ave, Yakima, WA 989023315 | 5095755000 | 5094546193 |
| 502 W 4th Ave, Toppenish, WA 989481616 | 5098653105 | 5098651519 |
| Street Address |
601 MARTIN LUTHER KING AVE NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87102-3619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669433017 | William M Roethel | Emergency Medicine | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2006-03-28 |
| 1609364249 | Dominique Pummill | Nurse Practitioner | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2018-04-30 |
| 1730335860 | Leslie Anne Miller | Occupational Therapist | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2008-08-08 |
| 1518137041 | Lovelace Health System Inc | Psychiatric Unit | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2008-03-12 |
| 1275711178 | Lovelace Health Systems LLC | Internal Medicine | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2008-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454937 | Julie Wood | Acupuncturist | 1600 Luna Circle Nw, Albuquerque, NM 87102 | 2020-10-16 |
| 1770121410 | Emily Perez | Counselor | 218 Broadway Ne, Albuquerque, NM 87102 | 2019-12-12 |
| 1417503392 | Tess Holtry | Behavior Technician | 1424 Walter St Nw, Albuquerque, NM 87102 | 2019-08-15 |
| 1942867486 | Christy E Cheromiah | Behavioral Analyst | Open Skies Helathcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-05-21 |
| 1730744103 | Faith Petra Maxwell | Behavior Technician | 900 Arno St, Albuquerque, NM 87102 | 2019-05-01 |
| 1568923761 | Storm Swinford | Behavioral Analyst | Open Skies Healthcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-29 |
| 1093276651 | Tina Marie Trujillo | Behavioral Analyst | Open Skies Health Care, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-27 |
| 1861950370 | Meghan Montoya | Student in an Organized Health Care Education/Training Program | 801 Camino De Salud, Albuquerque, NM 87102 | 2019-03-05 |
| 1174099329 | Dilshani N Tyson | Counselor | 600 1st Street Nw Ste 200, Albuquerque, NM 87102 | 2018-10-15 |
| 1962987925 | Tania L Goldfeder | Social Worker | New Mexico Solutions, 707 Broadway Ne Suite 500, Albuquerque, NM 87102 | 2018-09-26 |
| Find all providers in zip 87102 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730612359 | Adam Michael Tolar | Emergency Medicine | Mcs 11 6025, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2017-04-10 |
| 1538691712 | David Scott Fischman | Emergency Medicine | 6400 Paseo Del Norte Blvd Ne, Albuquerque, NM 87113-8711 | 2017-03-28 |
| 1265895486 | Nedda Fariba Karimi | Emergency Medicine | 4515 Coors Blvd Nw, Albuquerque, NM 87120-3699 | 2016-04-04 |
| 1417310764 | Justin Itty Mathew | Emergency Medicine | Department of Emergency Medicine Msc11 6025, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2016-04-04 |
| 1639532583 | Amanda Lauren Ventura | Emergency Medicine | Msc Emergency Medicine 1 University of New Mexico, Albuquerque, NM 87131-2364 | 2016-03-29 |
| 1083000178 | David Michael Glass | Emergency Medicine | Emergency Medicine Msc 11 6025, University of New Mexico, Albuquerque, NM 87131-0001 | 2015-04-15 |
| 1952797300 | Eleni Marie Bucuvalas | Emergency Medicine | Msc 11-6025, 1 University of New Mexico, Albuquerque, NM 87131 | 2015-04-13 |
| 1225423239 | Joseph Smith Jr. | Emergency Medicine | Msc 11 6025 University of New Mexico, Albuquerque, NM 87131-0001 | 2015-04-06 |
| 1073932471 | Kimberly Marie Ruth Pruett | Emergency Medicine | Unm Department of Emergency Medicine 1 Unm, Albuquerque, NM 87131-4700 | 2014-04-14 |
| 1538509484 | Jason S. Zeller | Emergency Medicine | Msc 11 6025 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-06-25 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87102 |
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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.