JAMES M. WILTERDING, M.D., LLC (NPI# 1174622666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174622666 |
| Entity Type | Organization |
| Organization Name | JAMES M. WILTERDING, M.D., LLC |
| Practice Address |
711 Encino Pl Ne Suite D Albuquerque NM 87102-2619 |
| Practice Telephone | 5052652244 |
| Practice Fax Number | 5052650557 |
| Mailing Telephone | 5052652244 |
| Mailing Fax Number | 5052650557 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES M. WILTERDING (OWNER) |
| Authorized Official Telephone | 5052652244 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
2003-0249 | NM | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 61238015 | 05 | |
| NM | BLUE CROSS BLUE SHIELD | NM009M95 | 01 |
| NM | MOLINA SALUD | PROVP16828 | 01 |
| Street Address |
711 ENCINO PL NE SUITE D |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87102-2619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245208867 | Thomas Henry Bien | Psychologist | 711 Encino Pl Ne, Suite D, Albuquerque, NM 87102-2619 | 2006-03-09 |
| 1205068236 | George Higgins Family Practice LLC | Clinic/Center | 711 Encino Pl Ne, Suite D, Albuquerque, NM 87102-2619 | 2009-08-08 |
| 1003006040 | New Mexico Surgical Associates, Pa | Specialist | 711 Encino Pl Ne, Albuquerque, NM 87102-2619 | 2007-07-26 |
| 1770609497 | Podiatry Associates of New Mexico Ltd | Podiatrist | 711 Encino Pl Ne, Suite G, Albuquerque, NM 87102-2619 | 2007-03-22 |
| 1124179486 | Donald Lee Kettwich | Urology | 711 Encino Pl Ne, Suite E, Albuquerque, NM 87102-2619 | 2007-01-15 |
| 1154412740 | Scott Brown Md LLC | Family Medicine | 711 Encino Pl Ne, Suite D, Albuquerque, NM 87102-2619 | 2006-09-27 |
| 1205843240 | Scott Brown | Family Medicine | 711 Encino Pl Ne, Suite D, Albuquerque, NM 87102-2619 | 2006-08-02 |
| 1972565539 | Joseph P Lopez | Specialist | 711 Encino Pl Ne, Albuquerque, NM 87102-2619 | 2006-04-06 |
| 1831151497 | Robert J Lowe | Specialist | 711 Encino Pl Ne, Albuquerque, NM 87102-2619 | 2006-04-06 |
| 1487641981 | Stephen Lampkin Gregg | Internal Medicine | 711 Encino Pl Ne, Suite B, Albuquerque, NM 87102-2619 | 2005-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407454937 | Julie Wood | Acupuncturist | 1600 Luna Circle Nw, Albuquerque, NM 87102 | 2020-10-16 |
| 1770121410 | Emily Perez | Counselor | 218 Broadway Ne, Albuquerque, NM 87102 | 2019-12-12 |
| 1417503392 | Tess Holtry | Behavior Technician | 1424 Walter St Nw, Albuquerque, NM 87102 | 2019-08-15 |
| 1942867486 | Christy E Cheromiah | Behavioral Analyst | Open Skies Helathcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-05-21 |
| 1730744103 | Faith Petra Maxwell | Behavior Technician | 900 Arno St, Albuquerque, NM 87102 | 2019-05-01 |
| 1568923761 | Storm Swinford | Behavioral Analyst | Open Skies Healthcare, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-29 |
| 1093276651 | Tina Marie Trujillo | Behavioral Analyst | Open Skies Health Care, 707 Broadway Blvd Ne, Albuquerque, NM 87102 | 2019-03-27 |
| 1861950370 | Meghan Montoya | Student in an Organized Health Care Education/Training Program | 801 Camino De Salud, Albuquerque, NM 87102 | 2019-03-05 |
| 1174099329 | Dilshani N Tyson | Counselor | 600 1st Street Nw Ste 200, Albuquerque, NM 87102 | 2018-10-15 |
| 1962987925 | Tania L Goldfeder | Social Worker | New Mexico Solutions, 707 Broadway Ne Suite 500, Albuquerque, NM 87102 | 2018-09-26 |
| Find all providers in zip 87102 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417591413 | Old Town Primary Care, Inc. | Clinic/Center | 501 14th St Nw, Albuquerque, NM 87104-1729 | 2019-11-01 |
| 1700269412 | Adler Medical LLC | Clinic/Center | 4241 Montgomery Blvd Ne, Albuquerque, NM 87109-1081 | 2015-06-30 |
| 1306158860 | Luma Kai, LLC | Clinic/Center | 3701 San Mateo Blvd Ne, Albuquerque, NM 87110-1230 | 2010-07-12 |
| 1225357981 | Lovelace Health System, Inc. | Clinic/Center | 11000 Broadway Blvd Se, Suite 1, Albuquerque, NM 87105-7469 | 2010-05-20 |
| 1124177696 | Torre D. Near D/b/a Statmed LLC | Clinic/Center | 3916 Carlisle Blvd Ne, Suite G, Albuquerque, NM 87107-4556 | 2007-01-10 |
| 1356405369 | St. Christopher Inc | Clinic/Center | 2800 San Mateo Blvd Ne, Suite 107, Albuquerque, NM 87110-3135 | 2006-12-21 |
| 1316545882 | Kingsley Clinic of New Mexico, LLC | Clinic/Center | 6300 Riverside Plaza Ln Nw Ste 100, Albuquerque, NM 87120-1908 | 2020-10-15 |
| 1902324692 | Turquoise Trail Primary Care LLC | Clinic/Center | 3825 Eubank Blvd Ne Ste C, Albuquerque, NM 87111-3559 | 2017-09-01 |
| 1831636687 | Nancy Elliott | Clinic/Center | 8300 Constitution Ne, Room 1303, Albuquerque, NM 87110 | 2017-01-31 |
| 1255784658 | Hippocare, Inc | Clinic/Center | 3911 4th St Nw Ste B, Albuquerque, NM 87107-2510 | 2016-07-20 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87102 |
Please comment or provide details below to improve the information on JAMES M. WILTERDING, M.D., LLC.
| 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.