SUSAN J SMITH (NPI# 1619013869) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619013869 |
| Entity Type | Individual |
| Full Name | SUSAN J SMITH |
| Credential | CNP |
| Practice Address |
9640 Menaul Blvd Ne Cvs Minute Clinic Albuquerque NM 87112-2217 |
| Mailing Address |
9640 Menaul Blvd Ne Albuquerque NM 87112-2217 |
| Practice Telephone | 5052944167 |
| Mailing Telephone | 5052944167 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2015-01-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | R30405 | NM | Allopathic & Osteopathic Physicians |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
R30405 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 000Q2493 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407347297 | Susan Banuelos Smith | Dietitian, Registered | 3801 W 15th St Ste 214, Plano, TX 75075 | 2018-05-29 |
| 1447751870 | Susan Allen Smith | Registered Nurse | 1210 Terrace Dr, Mesquite, TX 75150-4284 | 2018-02-21 |
| 1326585407 | Susan A Smith | Nutritionist | 1114 Hidden Spring Dr, Naperville, IL 60540-4112 | 2017-01-26 |
| 1588115067 | Susan Smith | Counselor | 8491 N. Lake Blvd., Kings Beach, CA 96143 | 2016-10-19 |
| 1508316712 | Susan Taylor Smith | Speech-Language Pathologist | 120 Brundage Ter, Hot Springs, AR 71913-9348 | 2016-10-12 |
| 1326595075 | Susan Smith | Physical Therapist | 1115 E Hampton Dr, Pearland, TX 77584-7620 | 2016-09-09 |
| 1740656115 | Susan Smith | Counselor | 108089 S 4670 Rd, Sallisaw, OK 74955-8587 | 2015-08-19 |
| 1902282734 | Susan Smith | Physical Therapist | 4 Carville Ave, Lexington, MA 02421-6212 | 2015-08-04 |
| 1790173110 | Susan Smith | Speech-Language Pathologist | 301 Haig Dr, Wilmington, NC 28412-7134 | 2015-01-07 |
| 1598180218 | Susan Smith I | Counselor | 2819 Teasdale Dr, Troy, MI 48083-2657 | 2014-03-04 |
| Street Address |
9640 MENAUL BLVD NE CVS MINUTE CLINIC |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87112-2217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013517721 | Sarthak Patel | Pharmacy | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2020-10-30 |
| 1710502117 | Alejandro Salcido | Nurse Practitioner | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2020-06-11 |
| 1447883749 | Sheila Mae Talido Kourakos | Registered Nurse | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2020-02-15 |
| 1467905356 | Stephanie Welch | Nurse Practitioner | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2016-07-27 |
| 1730563172 | Joshua Larson | Nurse Practitioner | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2015-07-15 |
| 1043619919 | Jamie Larson | Nurse Practitioner | 9640 Menaul Blvd Ne, Albuquerque, NM 87112 | 2014-08-17 |
| 1750715256 | Jennifer Ewa Ryba | Pharmacist | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2013-09-03 |
| 1568706745 | Joseph Granata | Pharmacist | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2012-11-12 |
| 1841541471 | Michael Joseph Gutierrez | Pharmacist | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2012-09-22 |
| 1417206962 | Tracy William Forward | Pharmacist | 9640 Menaul Blvd Ne, Albuquerque, NM 87112-2217 | 2012-08-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356999411 | Lynn Eileen Riley | Counselor | 10205 Stovall Pl Ne, Albuquerque, NM 87112 | 2019-08-30 |
| 1548818222 | Cindy D Montoya | Technician | 11405 Snow Heights Blvd Ne, Albuquerque, NM 87112 | 2019-08-27 |
| 1194387449 | Karen Sue Stockham | Counselor | 9024 Aspen Ave Ne, Albuquerque, NM 87112 | 2019-07-07 |
| 1316416837 | New Beginning Counseling Services Inc | Counselor | 2617 Juan Tabo Blvd Ne Unit A/d, Albuquerque, NM 87112 | 2018-11-14 |
| 1306365929 | Calyx Institute LLC | Social Worker | 10701 Lomas Blvd Ne, Ste. 101, Albuquerque, NM 87112 | 2017-09-14 |
| 1811411135 | Annette Romero | Case Manager/Care Coordinator | 9741 Candelaria, Albuquerque, NM 87112 | 2017-07-28 |
| 1851814784 | Ally Renee Funkhouser Dye | Pediatrics | 2130 Eubank Blvd Ne, Albuquerque, NM 87112 | 2017-07-23 |
| 1508303140 | Makena Bailey Nash | Behavior Technician | 12801 Indian School Ne Apt 508, Albuquerque, NM 87112 | 2017-01-20 |
| 1477978906 | Albert R Toya | Massage Therapist | 2601 Wyoming Blvd N.e. Room 115-c, Albuquerque, NM 87112 | 2014-02-20 |
| 1184918104 | Jennifer E Chavez | Counselor | 1505 Marron Circle Ne, Albuquerque, NM 87112 | 2011-06-07 |
| Find all providers in zip 87112 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063027696 | Comprehensive Gastrostomy Tube Cares, LLC | Family Medicine | 8100 Wyoming Blvd Ne Ste M4-701, Albuquerque, NM 87113-1946 | 2020-09-10 |
| 1740898428 | Dr. Maggie Wilson, PC | Family Medicine | 717 Encino Pl Ne Ste 5, Albuquerque, NM 87102-2624 | 2020-07-17 |
| 1831734813 | Leandra Lee Medina | Family Medicine | 7050 Barstow St Ne Ste B, Albuquerque, NM 87111-1056 | 2019-11-13 |
| 1093374589 | Palliative and Transitional Care of Nm LLC | Family Medicine | 805 Guadalupe Cir Nw, Albuquerque, NM 87114-1710 | 2019-06-10 |
| 1649834904 | Mederi Life LLC | Family Medicine | 4325 Carlisle Blvd Ne Ste B, Albuquerque, NM 87107-4826 | 2019-04-23 |
| 1649733619 | Susan Giron | Family Medicine | 6704 Baker Ave Ne, Albuquerque, NM 87109-2746 | 2019-04-08 |
| 1982163267 | Nm Spirit of Wellness LLC | Family Medicine | 123 Girard Blvd Se, Albuquerque, NM 87106-2227 | 2019-03-18 |
| 1891266458 | Karen Ann Longenecker | Family Medicine | 2300 Menaul Blvd Ne Fl 3, Albuquerque, NM 87107-1851 | 2018-12-07 |
| 1144797135 | Erin Aleisha Langford | Family Medicine | 4588 Paradise Blvd Nw # 100, Albuquerque, NM 87114-4105 | 2018-10-28 |
| 1740761972 | Maria Marcela Colom Bickford | Family Medicine | Msc 09-5040 I University of New Mexico, Albuquerque, NM 87131 | 2018-08-26 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87112 |
Please comment or provide details below to improve the information on SUSAN J SMITH.
| 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.