MR. IAN VANDERWOUDE (NPI# 1851686414) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851686414 |
| Entity Type | Individual |
| Full Name | MR. IAN VANDERWOUDE |
| Credential | PA-C, MSPAS |
| Practice Address |
9210 Golf Course Rd Nw Albuquerque NM 87114-5891 |
| Practice Telephone | 5058993933 |
| Mailing Telephone | 5058993933 |
| Enumeration Date | 2011-06-12 |
| Last Update Date | 2011-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA2011-0015 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
9210 GOLF COURSE RD NW |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87114-5891 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073578456 | Amy Johnson | Emergency Medicine | 9210 Golf Course Rd Nw, Albuquerque, NM 87114-5891 | 2006-04-19 |
| 1093372070 | Nicole Theresa Rees | Physician Assistant | 9210 Golf Course Rd Nw, Albuquerque, NM 87114-5891 | 2019-05-24 |
| 1033485693 | Laura L Abeyta | Pediatrics | 9210 Golf Course Rd Nw, Albuquerque, NM 87114 | 2012-03-28 |
| 1912046939 | Yolandra Toya | Pediatrics | 9210 Golf Course Rd Nw, Albuquerque, NM 87114-5891 | 2007-02-06 |
| 1619902806 | Lisa A Jimenez | Pediatrics | 9210 Golf Course Rd Nw, Albuquerque, NM 87114-5891 | 2006-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891331773 | Head To Toe Wellness, LLC | Counselor | 4619 Greene Ave, Suite D, Albuquerque, NM 87114 | 2019-11-26 |
| 1255896353 | 32 Degrees Genuine, LLC | Counselor | 10143 4th St Nw, Albuquerque, NM 87114 | 2019-02-04 |
| 1548789365 | Maureen Chavez | Occupational Therapist | 10501 Golf Course, Albuquerque, NM 87114 | 2017-09-13 |
| 1982149043 | Professional Case Coordination Services LLC | Case Management | 4401 Aspen Glade Dr Nw, Albuquerque, NM 87114 | 2016-12-28 |
| 1124494323 | Geri Davis | Nurse Practitioner | 10511 Golf Course Rd Nw Ste 203, Albuquerque, NM 87114 | 2015-08-11 |
| 1427432111 | Marcia Nicole Cowen | Nurse Practitioner | 9210 Golfcourse Rd Nw, Albuquerque, NM 87114 | 2015-07-13 |
| 1013315399 | Amy Brown | Counselor | 707 Broadway Blvd. Ne, Suite 500, Albuquerque, NM 87114 | 2014-12-18 |
| 1851793392 | Elaine Barbara Beckett | Pharmacist | 10224 Coors-by-pass Nw, Albuquerque, NM 87114 | 2014-09-16 |
| 1174924344 | Sherrica Cressor | Counselor | 20 Pond Road, County Road 11, Cuba, NM 87114 | 2014-09-08 |
| 1427467513 | Colleen Temkin | Pharmacist | 10224 Coors By Pass Nw, Albuquerque, NM 87114 | 2014-08-04 |
| Find all providers in zip 87114 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386284602 | Christopher Whorley | Physician Assistant | 4683 Idlewilde Ln Se, Albuquerque, NM 87108-3421 | 2020-01-15 |
| 1053836809 | Alysha Gallegos | Physician Assistant | 6112 Molinero Ct Sw, Albuquerque, NM 87105-6814 | 2017-08-13 |
| 1306225180 | Allison Rose Crossey | Physician Assistant | 201 Cedar Street Se, Suite 6600, Albuquerque, NM 87106 | 2015-05-26 |
| 1336543115 | Pamela O Black Md, P.a., Dba Quadra Health Institute | Physician Assistant | 3820 Commons Ave Ne # M, Albuquerque, NM 87109-5831 | 2014-10-22 |
| 1457686511 | Bayle R. Curtis | Physician Assistant | 1806 Morningrise Pl Se, Albuquerque, NM 87108-4520 | 2009-10-07 |
| 1215173919 | Amber Dawn Hansen | Physician Assistant | 1100 Cenrral Ave Se, Albuquerque, NM 87106 | 2008-12-30 |
| 1508028606 | Angela Genette Baumeister | Physician Assistant | 707 13th St Nw, Albuquerque, NM 87102-1841 | 2008-06-30 |
| 1528230117 | Laura Wylie | Physician Assistant | 1101 Medical Arts Ave Ne # 4, Building 4, Suite A, Unm Senior Health, Albuquerque, NM 87102-2706 | 2008-03-24 |
| 1457406951 | Deneen Tomayko | Physician Assistant | 2211 Lomas Blvd Ne Fl 4, Albuquerque, NM 87106-2745 | 2007-01-24 |
| 1083793665 | Karen Kay Nester | Physician Assistant | 4901 Lang Ave, Ne, Suite 100, Albuquerque, NM 87109-4597 | 2006-11-03 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87114 |
Please comment or provide details below to improve the information on MR. IAN VANDERWOUDE.
| 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.