J FREDRIC BLACKLEY (NPI# 1922104322) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922104322 |
| Entity Type | Individual |
| Full Name | J FREDRIC BLACKLEY |
| Credential | MD |
| Practice Address |
5400 Gibson Se Albuquerque NM 87108 |
| Mailing Address |
5400 Gibson Se Blvd Po Box 27829 Albuquerque NM 87125 |
| Practice Telephone | 5052627026 |
| Practice Fax Number | 5057279276 |
| Mailing Telephone | 5052627026 |
| Mailing Fax Number | 5057279276 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
70-16 | NM | Allopathic & Osteopathic Physicians |
| Street Address |
5400 GIBSON SE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235162827 | Margaret M Hoemeke | Physician Assistant | 5400 Gibson Se, Albuquerque, NM 87108 | 2006-07-08 |
| 1225104946 | Lauri Lynn Montanez | Nurse Practitioner | 5400 Gibson Se, Lovelace Medical Center, Albuquerque, NM 87108 | 2006-11-27 |
| 1417023136 | Keith W Harvie | Orthopaedic Surgery | 5400 Gibson Se, Lovelace Medical Center, Albuquerque, NM 87108 | 2006-11-27 |
| 1508947466 | Phillip J Steinbaugh | Physician Assistant | 5400 Gibson Se, Albuquerque, NM 87108 | 2006-10-18 |
| 1245311034 | Teresa V Balcomb | Surgery | 5400 Gibson Se, Albuquerque, NM 87108 | 2006-10-18 |
| 1265524177 | Kevin Jay Regan | Physician Assistant | 5400 Gibson Se, Lovelace Medical Center, Albuquerque, NM 87108 | 2006-09-28 |
| 1770683617 | Carolyn Johns | Nurse Practitioner | 5400 Gibson Se, Lovelace Medical Center, Albuquerque, NM 87108 | 2006-09-22 |
| 1851401723 | Bernard David Shepen | Internal Medicine | 5400 Gibson Se, Albuquerque, NM 87108 | 2006-08-30 |
| 1689681207 | John B Griffin | Audiologist | 5400 Gibson Se, Albuquerque, NM 87108 | 2006-08-03 |
| 1477569093 | Diane Vanek | Podiatrist | 5400 Gibson Se, Albuquerque, NM 87108 | 2006-08-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588274393 | Aubrey Bunnenberg | Behavior Technician | 114 Pennsyvlania St. Ne Apt. 1, Albuquerque, NM 87108 | 2020-08-06 |
| 1336757301 | Dailey Doss | Physician Assistant | Raymond G. Murphy Va Medical Center, 1501 San Pedro Se, Albuquerque, NM 87108 | 2020-07-16 |
| 1457990046 | Christine Lovato | Registered Nurse | Albuquerque Treatment Services LLC, 123 Madeira Dr Se, Albuquerque, NM 87108 | 2019-12-30 |
| 1265074405 | Andrew Jacob Reuter | Pharmacist | 3816 Copper Ave Ne, Unit A, Albuquerque, NM 87108 | 2019-10-09 |
| 1518517325 | Lillian Abeyta | Technician | 1501 San Pedro Dr Se., Albuquerque, NM 87108 | 2019-09-13 |
| 1962970061 | Donald Borrego | Occupational Therapy Assistant | 5200 Copper Ne, #7, Albuquerque, NM 87108 | 2018-11-06 |
| 1154808012 | Catalina Castro | Social Worker | 209 San Pablo Se, Albuquerque, NM 87108 | 2018-07-24 |
| 1942721048 | Walgreen Co | Pharmacy | 933 San Mateo Blvd Ne Ste 501, Albuquerque, NM 87108 | 2017-06-29 |
| 1467981860 | Jennifer Martinez | Behavior Technician | 628 Espanola Se, Albuquerque, NM 87108 | 2017-06-08 |
| 1457892465 | J Dowd Counseling LLC | Counselor | 514 Monroe Street Se, Albuquerque, NM 87108 | 2017-03-10 |
| Find all providers in zip 87108 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124658299 | City Mobile Ultrasound, LLC | Radiology | 524 Richmond Dr Se, Albuquerque, NM 87106-2328 | 2020-01-17 |
| 1013407964 | Erika Jane Starks | Radiology | Radiology Msc 10-5530 1 University of New Mexico, Albuquerque, NM 87131-5040 | 2018-05-16 |
| 1700229523 | Martha F Terrazas | Radiology | Msc 10 5530 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-04-11 |
| 1922341585 | Katherine Nicole Epstein | Radiology | Msc10 5530 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-04-02 |
| 1962745869 | Joshua Eric Rider | Radiology | Unmh, 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2013-03-29 |
| 1346506904 | Andrew Bruner | Radiology | Msc 10-5550 1, University of New Mexico, Albuquerque, NM 87131 | 2012-04-09 |
| 1942576145 | Douglas James Alden | Radiology | 373 Big Horn Ridge Dr Ne, Albuquerque, NM 87122-1424 | 2012-04-02 |
| 1689947921 | Robert Johnson | Radiology | 804 Piedra Vista Rd Ne, Albuquerque, NM 87123-1954 | 2012-02-16 |
| 1386936623 | Matthew Stevens Myers | Radiology | Graduate Medical Education Msc 116093, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2011-05-04 |
| 1346530409 | Amirkasra Mojtahed | Radiology | 4352 Altura Mesa Ln Ne, Albuquerque, NM 87110-5059 | 2011-04-11 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87108 |
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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.