DR. LARRY RUSSEL CLEVENGER (NPI# 1558404202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558404202 |
| Entity Type | Individual |
| Full Name | DR. LARRY RUSSEL CLEVENGER |
| Credential | M.D. |
| Practice Address |
1515 Eubank Blvd Ne Albuquerque NM 87112-4112 |
| Practice Telephone | 5058458037 |
| Mailing Telephone | 5058458037 |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2013-09-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083X0100X |
Preventive Medicine Specialization: Occupational Medicine |
75-126 | NM | Allopathic & Osteopathic Physicians |
| Street Address |
1515 EUBANK BLVD NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87112-4112 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518348861 | Mariano Gallegos | Technician, Pathology | 1515 Eubank Blvd Ne, Bldg 831/832, Albuquerque, NM 87112-4112 | 2015-06-12 |
| 1386991685 | Michele Paula Fitzpatrick | Registered Nurse | 1515 Eubank Blvd Ne, Albuquerque, NM 87112-4112 | 2012-08-07 |
| 1063693141 | Rio Bravo Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1515 Eubank Blvd Ne, Albuquerque, NM 87112-4112 | 2007-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356999411 | Lynn Eileen Riley | Counselor | 10205 Stovall Pl Ne, Albuquerque, NM 87112 | 2019-08-30 |
| 1548818222 | Cindy D Montoya | Technician | 11405 Snow Heights Blvd Ne, Albuquerque, NM 87112 | 2019-08-27 |
| 1194387449 | Karen Sue Stockham | Counselor | 9024 Aspen Ave Ne, Albuquerque, NM 87112 | 2019-07-07 |
| 1316416837 | New Beginning Counseling Services Inc | Counselor | 2617 Juan Tabo Blvd Ne Unit A/d, Albuquerque, NM 87112 | 2018-11-14 |
| 1306365929 | Calyx Institute LLC | Social Worker | 10701 Lomas Blvd Ne, Ste. 101, Albuquerque, NM 87112 | 2017-09-14 |
| 1811411135 | Annette Romero | Case Manager/Care Coordinator | 9741 Candelaria, Albuquerque, NM 87112 | 2017-07-28 |
| 1851814784 | Ally Renee Funkhouser Dye | Pediatrics | 2130 Eubank Blvd Ne, Albuquerque, NM 87112 | 2017-07-23 |
| 1508303140 | Makena Bailey Nash | Behavior Technician | 12801 Indian School Ne Apt 508, Albuquerque, NM 87112 | 2017-01-20 |
| 1477978906 | Albert R Toya | Massage Therapist | 2601 Wyoming Blvd N.e. Room 115-c, Albuquerque, NM 87112 | 2014-02-20 |
| 1184918104 | Jennifer E Chavez | Counselor | 1505 Marron Circle Ne, Albuquerque, NM 87112 | 2011-06-07 |
| Find all providers in zip 87112 | ||||
| Taxonomy Code | 2083X0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Occupational Medicine |
| Occupational medicine focuses on the health of workers, including the ability to perform work; the physical, chemical, biological, and social environments of the workplace; and the health outcomes of environmental exposures. Practitioners in this field address the promotion of health in the work place, and the prevention and management of occupational and environmental injury, illness, and disability. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114239522 | Miguel A. Perez Abreu | Preventive Medicine | 600 Wyoming Blvd Ne, Albuquerque, NM 87123 | 2010-07-14 |
| 1235467358 | Kendall Bryce Green | Preventive Medicine | 2400 Tucker, Family Practice Center Rm 232, Albuquerque, NM 87131-0001 | 2009-12-01 |
| 1619027505 | Rick Brownlow Sauerman | Preventive Medicine | 1515 Eubank Blvd Se, Albuquerque, NM 87123-3453 | 2007-01-11 |
| 1194874214 | Kimberly K Yeager | Preventive Medicine | 2400 Tucker Ne Msc09 5030, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2007-01-09 |
| 1245639756 | Vaccines for Health | Preventive Medicine | 1717 Louisiana Blvd Ne, Suite 212, Albuquerque, NM 87110-7001 | 2014-08-20 |
| 1447678131 | Steven Fishburn | Preventive Medicine | Msc 10 6000, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2014-03-31 |
| 1619157385 | Gwendolyn G Reyna | Preventive Medicine | 801 Encino Pl Ne, Suite E-12, Albuquerque, NM 87102-2612 | 2007-11-09 |
| 1174743710 | Juliana Garcia | Preventive Medicine | 3811 Commons Ave Ne, Albuquerque, NM 87109-5832 | 2007-04-26 |
| 1801915814 | Janice L Sperling | Preventive Medicine | 801 Encino Pl Ne, Suite E-12, Albuquerque, NM 87102-2612 | 2007-03-29 |
| 1497874929 | Guillermo Colocho | Preventive Medicine | 801 Encino Pl Ne, Suite E-12, Albuquerque, NM 87102-2612 | 2007-03-28 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87112 |
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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.