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SMALL TOWN FAMILY PRACTICE LLC
NPI 1164194940
Clinic/Center - Primary Care in Albuquerque, NM

Active since September 30, 2021
4225 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109(505) 366-3635(505) 221-5429 Get Directions Write a Review

NPPES record last updated: September 30, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Small Town Family Practice Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SMALL TOWN FAMILY PRACTICE LLC (NPI 1164194940) is a healthcare organization registered as a primary care in Albuquerque, New Mexico and active in the NPI registry since September 2021. The organization lists Deanna Rene Clark, Co-owner/ Co-manager, as its authorized official.

NPPES Registry Identity

NPI1164194940
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameSMALL TOWN FAMILY PRACTICE LLC
Location Address4225 MONTGOMERY BLVD NEAlbuquerque, NM 87109-1103
Mailing Address4225 Montgomery Blvd NeAlbuquerque, NM 87109-1103 · (505) 366-3635 · Fax (505) 221-5429
Phone(505) 366-3635
Fax(505) 221-5429
Organization SubpartNo
Authorized OfficialDeanna Rene ClarkCo-owner/ Co-manager · (505) 366-3635
Enumeration DateSeptember 30, 2021
NPPES CertifiedSeptember 30, 2021
✔ NPI 1164194940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedRegistered NurseTaxonomy 163W00000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · Primary CareTaxonomy 363LP2300X
4225 MONTGOMERY BLVD NE, Albuquerque, NM 87109
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CONSUELO GARVEY-SIERRA LISW
Social Worker
4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 881-1820
BRAYLIN RODRIGUEZ
Behavior Technician
4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 595-3505
LIFE STRATEGIES COUNSELING
Counselor (Mental Health)
4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 881-1820
COLLEEN ANN DOUGHERTY LMHC
Counselor (Mental Health)
4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 595-3505
DEANNA R CLARK CFNP
Nurse Practitioner (Family)
4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 366-3635
NM SMALL TOWN FAMILY PRACTICE, LLC
Clinic/Center (Primary Care)
4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 366-3635
505 DIAGNOSTICS LLC
Psychologist (Clinical)
4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 361-1931
DR. REBEKAH JAN HUTCHINS KHAN PHD
Counselor (Professional)
4225 MONTGOMERY BLVD NE
ALBUQUERQUE, NM 87109
Bernalillo County (505) 595-3505

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Small Town Family Practice LLC's NPI number?

The NPI number for Small Town Family Practice LLC is 1164194940. It was assigned to this organization in the NPPES registry on September 30, 2021.

Where is Small Town Family Practice LLC located?

Small Town Family Practice LLC is located at 4225 Montgomery Blvd NE, Albuquerque, NM 87109. The listed phone number is (505) 366-3635.

What is Small Town Family Practice LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Small Town Family Practice LLC was last updated on September 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.