DUKE CITY PRIMARY CARE
Complete NPI Record 1215580832
Family Medicine in Cedar Crest, NM
Active since July 23, 2019CLIA Certified · 10 labs
Complete NPI Dataset
This page contains the complete raw NPPES record for Duke City Primary Care (NPI 1215580832), a family medicine organization in Cedar Crest, NM. All 36 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1215580832 Field 1/36
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/36
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/36
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: MCLEOD MEDICAL CENTERS OF NM, INC. Field 4/36
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider Other Organization Name: DUKE CITY PRIMARY CARE Field 5/36
- Other name by which the organization provider is or has been known.
- Provider Other Organization Name Type Code: 3 Field 6/36
- Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
- Provider First Line Business Mailing Address: 12127B HWY 14 N STE 5 Field 7/36
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: CEDAR CREST Field 8/36
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: NM Field 9/36
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 870089557 Field 10/36
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/36
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 5052815180 Field 12/36
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 5052815320 Field 13/36
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 12127B HWY 14 N STE 5 Field 14/36
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: CEDAR CREST Field 15/36
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: NM Field 16/36
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 870089557 Field 17/36
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/36
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 5052815180 Field 19/36
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 5052815320 Field 20/36
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: LOPEZ-MARRUFO Field 23/36
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: CHRISTINA Field 24/36
- The first name of the authorized official.
- Authorized Official Middle Name: G. Field 25/36
- The middle name of the authorized official.
- Authorized Official Title or Position: CONTRACTS/CREDENTIALING SPECIALIST Field 26/36
- The title or position of the authorized official.
- Authorized Official Telephone Number: 5059166544 Field 27/36
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 207Q00000X Field 28/36
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 29/36
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 261QM0801X Field 30/36
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 31/36
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: Y Field 32/36
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Parent Organization LBN: MCLEOD MEDICAL CENTERS OF NM, INC. DBA DUKE CITY PRIMARY CARE Field 33/36
- The Legal Business Name (LBN) of the parent organization, if the provider is a subpart of a larger entity. This field identifies the official registered name of the parent company or organization under which the provider operates.
- Parent Organization TIN: Not available Field 34/36
- The Taxpayer Identification Number (TIN) of the parent organization, provided when the provider is a subpart of a larger entity. This field identifies the federal tax ID used by the parent organization for official and billing purposes.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 35/36
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 10
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
7200 Montgomery Blvd NE Ste 7121
Location 1/10Albuquerque, NM 87109-1510 · Phone (505) 872-0216 · Fax (505) 872-0635
4410 Irving Blvd NW
Location 2/10Albuquerque, NM 87114-5951 · Phone (505) 768-6123 · Fax (505) 897-5023
1901 Juan Tabo Blvd NE
Location 3/10Albuquerque, NM 87112-3303 · Phone (505) 407-2163 · Fax (505) 407-2125
11601 Montgomery Blvd NE
Location 4/10Albuquerque, NM 87111-2660 · Phone (505) 814-1333 · Fax (505) 990-3437
3121 Carlisle Blvd NE
Location 5/10Albuquerque, NM 87110-1654 · Phone (505) 228-2108 · Fax (505) 205-1514
11501 Montgomery Blvd NE
Location 6/10Albuquerque, NM 87111-2796 · Phone (505) 814-1333 · Fax (505) 990-3437
1202 Main St NE
Location 7/10Los Lunas, NM 87031-7409 · Phone (505) 565-0070 · Fax (505) 565-0978
1044 Main St NE
Location 8/10Los Lunas, NM 87031-7401 · Phone (505) 814-1333 · Fax (505) 990-3437
1851 Old US 66
Location 9/10Edgewood, NM 87015-7200 · Phone (505) 286-2396 · Fax (505) 286-2398
1108 W US Route 66
Location 10/10Moriarty, NM 87035-1006 · Phone (505) 832-4434 · Fax (505) 832-5024
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