Small Town Family Practice LLC
NPI 1164194940ActiveOrganization· Clinic/Center, Primary Care· Albuquerque, NM
Clinic/Center, Primary Care in Albuquerque, New Mexico, registered in NPPES in September 2021. The authorized official on file is Deanna Rene Clark, NURSE PRACTITIONER, Co-Owner/ Co-Manager.
Overview
| NPI | 1164194940 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 30, 2021 |
| Last updated in NPPES | Sep 30, 2021 |
| Certified by provider | Sep 30, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center, Primary Care Primary | 261QP2300X | — | — |
| Registered Nurse | 163W00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
| Nurse Practitioner, Primary Care | 363LP2300X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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