| New Mexico Center For Pain And Wellness, Llc | |
|
6330 Riverside Plaza Ln Nw Ste 100 Albuquerque NM 87120-2682 | |
| (505) 322-6687 | |
| (505) 369-3406 |
| Full Name | New Mexico Center For Pain And Wellness, Llc |
|---|---|
| Speciality | Pain Medicine |
| Location | 6330 Riverside Plaza Ln Nw Ste 100, Albuquerque, New Mexico |
| Authorized Official Name and Position | Christian Morris (OWNER) |
| Authorized Official Contact | 8018911038 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Mexico Center For Pain And Wellness, Llc 6330 Riverside Plaza Ln Nw Ste 100 Albuquerque NM 87120-2682 Ph: (505) 322-6687 | New Mexico Center For Pain And Wellness, Llc 6330 Riverside Plaza Ln Nw Ste 100 Albuquerque NM 87120-2682 Ph: (505) 322-6687 |
| NPI Number | 1033803143 |
|---|---|
| Provider Enumeration Date | 06/05/2023 |
| Last Update Date | 02/20/2024 |
| Medicare PECOS PAC ID | 7214391366 |
|---|---|
| Medicare Enrollment ID | O20230908000248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033803143 | NPI | - | NPPES |
| Provider Name | Alisha Beth Lowden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679969828 PECOS PAC ID: 0941520944 Enrollment ID: I20170504001357 |
| Provider Name | Maria Lynn Spangler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013433192 PECOS PAC ID: 4183999840 Enrollment ID: I20171005000534 |
| Provider Name | Dmitriy Vladimirovich Bazaron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043728249 PECOS PAC ID: 2567724743 Enrollment ID: I20180328001388 |
| Provider Name | Mark L Grossetete |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447592498 PECOS PAC ID: 3577798909 Enrollment ID: I20180906001151 |
| Provider Name | Francis E Carmel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336348432 PECOS PAC ID: 9830170224 Enrollment ID: I20180906002142 |
| Provider Name | Andrea D Carrillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306301551 PECOS PAC ID: 3971836123 Enrollment ID: I20190604000821 |
| Provider Name | Steven T Lackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649222910 PECOS PAC ID: 6800817776 Enrollment ID: I20190829000440 |
| Provider Name | Valerie L Conrad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992228571 PECOS PAC ID: 0446524391 Enrollment ID: I20200413000223 |
| Provider Name | Christian Morris |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1083078042 PECOS PAC ID: 8628409018 Enrollment ID: I20200519003267 |
| Provider Name | Kimberly A Bocaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699220335 PECOS PAC ID: 0749690113 Enrollment ID: I20201113002150 |
| Provider Name | Gerald Stephen Cotto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104541036 PECOS PAC ID: 4082084181 Enrollment ID: I20230106000760 |
| Provider Name | Christine Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306397195 PECOS PAC ID: 6507140456 Enrollment ID: I20230201002136 |
| Provider Name | Lynette Fay Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114413846 PECOS PAC ID: 5294100723 Enrollment ID: I20230413002747 |
| Provider Name | Angela Chinwendu Udemezue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902683766 PECOS PAC ID: 0143675744 Enrollment ID: I20231017004030 |
| Provider Name | Kristina Crews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033470711 PECOS PAC ID: 6103240387 Enrollment ID: I20231124000421 |
| Provider Name | Matthew J Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851097208 PECOS PAC ID: 1850828054 Enrollment ID: I20241230003092 |
| Provider Name | Marion Berryhill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295061695 PECOS PAC ID: 4183762594 Enrollment ID: I20250123001124 |
| Provider Name | Marisa Terry |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1114210085 PECOS PAC ID: 1052567377 Enrollment ID: I20250310001449 |
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