ADULT & PEDIATRIC UROLOGY, LLC (NPI# 1710190350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710190350 |
| Entity Type | Organization |
| Organization Name | ADULT & PEDIATRIC UROLOGY, LLC |
| Practice Address |
2300 E 30th St Bldg B Suite 106 Farmington NM 87401-8990 |
| Practice Telephone | 5053279111 |
| Practice Fax Number | 5053272730 |
| Mailing Telephone | 5053279111 |
| Mailing Fax Number | 5053272730 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ALLEN W MCCULLOCH (OWNER) |
| Authorized Official Telephone | 5053279111 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 87115 | NM | Allopathic & Osteopathic Physicians |
| Street Address |
2300 E 30TH ST BLDG B SUITE 106 |
| City | FARMINGTON |
| State | NM |
| Zip Code | 87401-8990 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689677791 | Joseph Perry Pope | Family Medicine | 2300 E 30th St, Bldg B, Farmington, NM 87401-8990 | 2005-05-23 |
| 1851751432 | Keith Maxwell Bull | Nurse Anesthetist, Certified Registered | 2300 E 30th St, Building A, Farmington, NM 87401-8990 | 2016-02-25 |
| 1861745945 | Melissa Lea-foster Rietz | Nurse Practitioner | 2300 E 30th St, Ste C2, Farmington, NM 87401-8991 | 2012-10-26 |
| 1922308782 | Craig Burgess | Pharmacist | 2300 E 30th St, Farmington, NM 87401-8990 | 2010-10-27 |
| 1912139452 | Richard Louis Hutchison, Md, PC | Plastic Surgery | 2300 E 30th St, Building B, Suite 103, Farmington, NM 87401-8990 | 2009-08-18 |
| 1518106004 | James F Burpee | Urology | 2300 E 30th St, Bldg B Suite 106, Farmington, NM 87401-8990 | 2009-02-06 |
| 1851412829 | Brett M. Clarke | Otolaryngology | 2300 E 30th St, Bldg D-102, Farmington, NM 87401-8990 | 2007-04-03 |
| 1528141843 | San Juan Regional Medical Center Inc | Psychiatry & Neurology | 2300 E 30th St, Building 102, Farmington, NM 87401-8990 | 2006-10-23 |
| 1265527642 | R Stephen Rankin | Pediatrics | 2300 E 30th St, Bldg C2, Farmington, NM 87401-8990 | 2006-10-03 |
| 1598879652 | Pinon Family Practice PC | Family Medicine | 2300 E 30th St, Bldg C-2, Farmington, NM 87401-8990 | 2006-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035192 | Jaylene Miller | Behavior Technician | 912 Fairgrounds Rd. Trl 36, Farmington, NM 87401 | 2020-08-28 |
| 1255940326 | John Andrew Martinez | Behavioral Analyst | 211 N Auburn, Farmington, NM 87401 | 2020-07-24 |
| 1598304990 | Chasitity Beulah Nez | Behavior Technician | 37 Rd 7101 #127, Farmington, NM 87401 | 2020-01-02 |
| 1205478575 | Micah Magee | Speech-Language Pathologist | Farmington High School, 2200 N. Sunset Ave, Farmington, NM 87401 | 2019-10-08 |
| 1831659754 | Lelilah Todacheene | Social Worker | 1204 Camina Real, Farmington, NM 87401 | 2019-03-25 |
| 1306323555 | Litany of Life | Counselor | 1010 Ridgeway Place, Farmington, NM 87401 | 2018-07-20 |
| 1093291213 | Brittany Bigham | Nurse Practitioner | 1001 W Broadway Ste E, Farmington, NM 87401 | 2018-07-11 |
| 1528556305 | Hairoun Home Health | Home Health | 1200 East 20th Street, Farmington, NM 87401 | 2018-04-26 |
| 1003338732 | Silver Tongue Speech & Voice, LLC | Clinic/Center | 3001 Northridge Dr Ste C, Farmington, NM 87401 | 2017-07-14 |
| 1902256621 | Capacity Builders Inc | Taxi | 418 W Broadway, Farmington, NM 87401 | 2016-06-14 |
| Find all providers in zip 87401 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164681326 | Jane A Suh | Urology | 21 Bradford Walk, Farmington, CT 06032-4530 | 2008-06-03 |
| 1003296534 | San Juan Regional Medical Center Inc | Urology | 2700 Farmington Ave, Building E, Suite 1, Farmington, NM 87401-4559 | 2015-05-29 |
| 1508279100 | Christian Edward Bartels | Urology | 270 Farmington Ave, Suite 352, Farmington, CT 06032-1909 | 2014-06-11 |
| 1457604001 | Hartford Healthcare Medical Group, Inc. | Urology | 399 Farmington Ave, Ste. 200, Farmington, CT 06032-1936 | 2012-10-19 |
| 1346520228 | Hartford Clinical Associates, PC | Urology | 399 Farmington Ave, Suite 200, Farmington, CT 06032-1936 | 2011-08-23 |
| 1376839837 | Richard Batstone Md Pa | Urology | 126 Middle St, Farmington, ME 04938-6937 | 2011-06-23 |
| 1811287782 | Daniel Brooks Mannas | Urology | 2700 Farmington Ave, Bldg E Ste 1, Farmington, NM 87401-4559 | 2011-04-13 |
| 1871813964 | Christopher Warren Taylor | Urology | 2700 Farmington Ave, Building E, Suite 1, Farmington, NM 87401-4559 | 2010-06-11 |
| 1578883559 | Gillian Wolff | Urology | 270 Farmington Ave, Farmington, CT 06032-1994 | 2010-06-02 |
| 1417287897 | Farmington Clinic Company LLC | Urology | 1101 Weber Rd, Suite 303, Farmington, MO 63640-3352 | 2010-01-06 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 87401 |
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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.