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NPI Code Detail

MEDICARE: MONOGRAM HEALTH PROFESSIONAL SERVICES OF NEW MEXICO LLC

MEDICARE: MONOGRAM HEALTH PROFESSIONAL SERVICES OF NEW MEXICO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RA0001XAdvanced Heart Failure and Transplant Cardiology Physician
2207RC0000XCardiovascular Disease Physician
3207RE0101XEndocrinology, Diabetes & Metabolism Physician
4207RP1001XPulmonary Disease Physician
52084P0800XPsychiatry Physician
6208D00000XGeneral Practice Physician
7103TB0200XCognitive & Behavioral Psychologist
8174400000XSpecialist
91835C0206XCardiology Pharmacist
10207Q00000XFamily Medicine Physician
11363L00000XNurse Practitioner
12363LF0000XFamily Nurse Practitioner
13363LP0808XPsychiatric/Mental Health Nurse Practitioner
14363A00000XPhysician Assistant
15207RN0300XNephrology Physician

General Provider Information

NPI Number : 1831804699
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONOGRAM HEALTH PROFESSIONAL SERVICES OF NEW MEXICO LLC
Provider Business Mailing Address
First Line : 5410 MARYLAND WAY STE 400
Second Line :
City : BRENTWOOD
State : TN
Zip : 37027-8087
Country : US
Telephone Number : 615-465-8684
Fax Number : 629-240-6003
Provider Business Practice Location Address
First Line : 500 MARQUETTE AVE NW STE 1200
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87102-5312
Country : US
Telephone Number : 615-673-4455
Fax Number :
Authorized Official
Title or Position : GENERAL COUNSEL AND SECRETARY
Name : SHAWN VERNER
Credential :
Telephone Number : 615-994-1889
Provider Enumeration Date : 01/17/2023
Last Update Date : 01/29/2025

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