MEDERI LIFE LLC (NPI# 1649834904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649834904 |
| Entity Type | Organization |
| Organization Name | MEDERI LIFE LLC |
| Practice Address |
4325 Carlisle Blvd Ne Ste B Albuquerque NM 87107-4826 |
| Practice Telephone | 5054334007 |
| Practice Fax Number | 5054334068 |
| Mailing Telephone | 5054334007 |
| Mailing Fax Number | 5054334068 |
| Enumeration Date | 2019-04-23 |
| Last Update Date | 2019-04-23 |
| Authorized Official Name | MRS. LISA PADILLA (PRACTICE MANAGER) |
| Authorized Official Telephone | 5053859060 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
4325 CARLISLE BLVD NE STE B |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87107-4826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589785 | Benjamin Argant | Behavior Technician | 331 Candelaria Road North East Suite A, Albuquerque, NM 87107 | 2020-08-20 |
| 1679138861 | Susan Luna, Lpcc LLC | Counselor | 3221 B Candelaria Ne, Albuquerque, NM 87107 | 2019-05-03 |
| 1407310881 | Eleanor Cloe Tibbetts | Speech-Language Pathologist | 7103 4th St. Nw Chatterbox Speech Therapy, Los Ranchos, NM 87107 | 2019-01-30 |
| 1386174829 | Triple D Medical Transportation, LLC. | Secured Medical Transport (VAN) | 2123 Menaul Blvd Ne Ste B, Albuquerque, NM 87107 | 2017-06-18 |
| 1487100715 | Kayleen Weinandt | Community/Behavioral Health | 3301 Los Arboles Ne, Albuquerque, NM 87107 | 2016-08-28 |
| 1811345549 | Inverse Medical, LLC | Non-emergency Medical Transport (VAN) | 1015 Cottonwood Dr. Suite J, Albuquerque, NM 87107 | 2016-06-03 |
| 1710349220 | Evolv Strong, LLC | Specialist/Technologist | 3201 Candelaria Rd Ne, Albuquerque, NM 87107 | 2016-03-23 |
| 1982072443 | Erik Robinson | Social Worker | 7801 Academy Road, Ne 2-200, Albueruque, NM 87107 | 2015-09-14 |
| 1033505763 | Sam Newmon Ma, Lpcc | Counselor | 320-h Osuna Rd Ne, Suite 4, Albuquerque, NM 87107 | 2015-04-09 |
| 1760896203 | Jocelyn Fiaschetti | Social Worker | 7704 4th Street Nw, Albuquerque, NM 87107 | 2014-06-12 |
| Find all providers in zip 87107 | ||||
| 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 |
| 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 |
| 1831678978 | Delsie Irene Morrison | Family Medicine | 400 Tijeras Ave Nw Ste 200, Albuquerque, NM 87102-3252 | 2018-08-09 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87107 |
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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.