FUNCTIONAL FAMILY MEDICINE (NPI# 1932509403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932509403 |
| Entity Type | Organization |
| Organization Name | FUNCTIONAL FAMILY MEDICINE |
| Practice Address |
7301 Jefferson St Ne Ste G Albuquerque NM 87109-4363 |
| Practice Telephone | 5052254044 |
| Practice Fax Number | 5055085284 |
| Mailing Telephone | 5052254044 |
| Mailing Fax Number | 5055085284 |
| Enumeration Date | 2014-09-02 |
| Last Update Date | 2014-09-02 |
| Authorized Official Name | CAMILLE JOHNSON (OWNER) |
| Authorized Official Telephone | 5055501183 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SF0001X |
Clinical Nurse Specialist Specialization: Family Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7301 JEFFERSON ST NE STE G |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 364SF0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Family Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174850291 | Clinica De La Gloria | Clinical Nurse Specialist | 1720 Bridge Blvd Sw Ste F, Albuquerque, NM 87105-3182 | 2009-11-10 |
| 1659805505 | New Mexico Health Care Clinicians Inc. | Clinical Nurse Specialist | 3911 4th St Nw, Suite A, Albuquerque, NM 87107-2510 | 2017-04-18 |
| 1215064399 | Mary Masuk | Clinical Nurse Specialist | 1111 Stanford Dr Ne, Albuquerque, NM 87106-3721 | 2007-02-27 |
| 1255480307 | Gloria Vigil | Clinical Nurse Specialist | 1720 Bridge Blvd Sw Ste F, Albuquerque, NM 87105-3182 | 2007-01-09 |
| 1740338086 | Virginia Valentine | Clinical Nurse Specialist | 6100 Pan American Freeway, Ne, Suite 390, Albuquerque, NM 87109-3401 | 2007-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932469210 | Brenda Jo Neikirk | Clinical Nurse Specialist | 2055 S Pacheco St Ste 300, Santa Fe, NM 87505-0504 | 2012-05-21 |
| 1972758688 | Country Medical Services, LLC | Clinical Nurse Specialist | Nm State Highway 120, #1252 (fyi Rural Address), Pob 203, Ocate, NM 87734-0203 | 2008-11-21 |
| 1336486984 | Julie Shoemake | Clinical Nurse Specialist | 1900 N Dal Paso St, Hobbs, NM 88240-3045 | 2013-01-15 |
| City | ALBUQUERQUE |
| Zip Code | 87109 |
Please comment or provide details below to improve the information on FUNCTIONAL FAMILY MEDICINE.
| 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.