IndividualActive
Kenneth Tisdale, L.C.I.C.I., LMT #548
NPI 1962709956 · Contractor · Albuquerque, NM
Kenneth Tisdale, L.C.I.C.I., LMT #548 is a Contractor provider in Albuquerque, NM (NPI 1962709956).
Provider details
- NPI number
- 1962709956
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Credential
- L.C.I.C.I., LMT #548
- Sex
- Male
- Sole proprietor
- Yes
- License
- LMT # 5488 (NM)
Specialties & taxonomies
Other Service Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
201 Eubank Blvd Ne
B1
Albuquerque, NM 87123
Phone: (505) 712-7585
Street-level locationGet directions
Mailing address
8400 Menaul Blvd
Albuquerque, NM 87112
Registry dates
- Enumerated
- 2011-02-28
- Last updated
- 2011-02-28
Frequently asked questions
- What is Kenneth Tisdale's NPI number?
- Kenneth Tisdale's National Provider Identifier (NPI) is 1962709956, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Kenneth Tisdale's specialty?
- Kenneth Tisdale is listed in the NPPES registry with a primary specialty of Contractor (Other Service Providers).
- Where is Kenneth Tisdale located?
- Kenneth Tisdale's practice location on file with NPPES is 201 Eubank Blvd Ne, Albuquerque, NM 87123.
- What is Kenneth Tisdale's phone number?
- The practice phone number listed in the NPPES registry for Kenneth Tisdale is (505) 712-7585.
- Is Kenneth Tisdale's NPI active?
- Yes — Kenneth Tisdale's NPI (1962709956) is active in the NPPES registry as of the last update on 2011-02-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.