PHC-LOS ALAMOS INC (NPI# 1023147097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023147097 |
| Entity Type | Organization |
| Organization Name | PHC-LOS ALAMOS INC |
| Practice Address |
3917 West Rd Los Alamos NM 87544-2275 |
| Mailing Address |
330 Seven Springs Way Brentwood TN 37027-4536 |
| Practice Telephone | 5056623452 |
| Mailing Telephone | 6159207000 |
| Mailing Fax Number | 6159208913 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2017-03-07 |
| Authorized Official Name | ROBERT N KLEIN (PRESIDENT) |
| Authorized Official Telephone | 6159207000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
Allopathic & Osteopathic Physicians | ||
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 96651067 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215005129 | Phc-los Alamos Inc | Medicare Defined Swing Bed Unit | 3917 West Rd, Los Alamos, NM 87544-2275 | 2006-11-30 |
| 1285701623 | Phc-los Alamos Inc | General Acute Care Hospital | 3917 West Rd, Los Alamos, NM 87544-2275 | 2006-11-29 |
| Street Address |
3917 WEST RD |
| City | LOS ALAMOS |
| State | NM |
| Zip Code | 87544-2275 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225031321 | Jan M Merin | Internal Medicine | 3917 West Rd, Los Alamos, NM 87544-2275 | 2005-05-23 |
| 1366089237 | Gonzalo A Diaz | Internal Medicine | 3917 West Rd, Los Alamos, NM 87544-2275 | 2019-12-10 |
| 1124576327 | Clay Schneider | Nurse Practitioner | 3917 West Rd, Los Alamos, NM 87544-2275 | 2016-09-15 |
| 1093167330 | Laura K Merrigan | Nurse Practitioner | 3917 West Rd, Suite A, Los Alamos, NM 87544-2275 | 2016-07-11 |
| 1043675473 | Total Renal Care Inc | Clinic/Center | 3917 West Rd, Ste G-02, Los Alamos, NM 87544-2275 | 2015-12-30 |
| 1225414253 | Sarah Versackas | Registered Nurse | 3917 West Rd, Suite A, Los Alamos, NM 87544-2275 | 2015-07-31 |
| 1700273745 | Apogee Medical Group | General Acute Care Hospital | 3917 West Rd, Los Alamos, NM 87544-2275 | 2015-04-16 |
| 1679965883 | Los Alamos Emergency Medical Associates Inc | Emergency Medicine | 3917 West Rd, Los Alamos, NM 87544-2275 | 2015-02-25 |
| 1659773612 | Eric Jonathan Krinsky | Physician Assistant | 3917 West Rd, Suite 150, Los Alamos, NM 87544-2275 | 2014-09-22 |
| 1740681311 | Robin Jean Norman | Physician Assistant | 3917 West Rd, Suite 150, Los Alamos, NM 87544-2275 | 2014-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679945935 | Zia Home Health | Home Health | 1475 Central Ave., Suite 125, Los Alamos, NM 87544 | 2015-10-27 |
| 1295131167 | Sara Pocernik | Dietitian, Registered | 1450 Iris Street, Los Alamos, NM 87544 | 2014-11-05 |
| 1760824890 | Lisa Renee Marr Lyon | Psychologist | 3917 West Road, Suite 128, Children's Clinic, P.a., Los Alamos, NM 87544 | 2013-07-17 |
| 1558629725 | Rachel Meyer | Dentist | 112 Central Park Square, Los Alamos, NM 87544 | 2012-04-25 |
| 1902183908 | Susana T. Chavarria | Occupational Therapist | 5 Quemazon Pl., Los Alamos, NM 87544 | 2011-11-04 |
| 1881998664 | Dr. Tom Child and Adolescent Medicine | Pediatrics | Los Alamos Medical Center, 3917 West Rd, Suite M250, Los Alamos, NM 87544 | 2011-01-07 |
| 1952565905 | Dawn Judy Barr | Social Worker | 3 Agila Ct, Los Alamos, NM 87544 | 2008-07-17 |
| 1649452129 | Ellen Vandergust Ballard | Dentist | 111 Longview, Suite B-3, White Rock, NM 87544 | 2007-11-27 |
| 1629290283 | Wildwind Dental | Dentist | 111 Longview Drive, Suite B3, Los Alamos, NM 87544 | 2007-05-03 |
| 1255407342 | Sarah Sue Teasdale | Counselor | 1362 C Trinity Dr, Los Alamos, NM 87544 | 2006-11-28 |
| Find all providers in zip 87544 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215230644 | Barbara Lynn Schmeits Hapke | Emergency Medicine | Country Road A-78, Private Road 2001 #18, Raton, NM 87740-0446 | 2010-12-07 |
| 1699807248 | Alfred William Neely | Emergency Medicine | 22 Meadow Hawk Ln, Silver City, NM 88022-9727 | 2007-03-09 |
| 1972682078 | Elin Mckinnon Ritchie | Emergency Medicine | Hc 74 Box 21913, El Prado, NM 87529 | 2006-11-02 |
| 1952366700 | Philip Seidenberg | Emergency Medicine | Unm Department of Emergency Medicine Msc10, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2006-04-17 |
| 1669433017 | William M Roethel | Emergency Medicine | 601 Martin Luther King Ave Ne, Albuquerque, NM 87102-3619 | 2006-03-28 |
| 1427039759 | Warner J Anderson | Emergency Medicine | 218 Cousins Road, Vanderwagen, NM 87326 | 2005-11-14 |
| 1003800822 | James D Schmitz | Emergency Medicine | 42 S Florida Ave, Alamogordo, NM 88310-9533 | 2005-09-08 |
| 1245891647 | Abq Ip LLC | Emergency Medicine | 9310 Coors Blvd Nw, Albuquerque, NM 87114-4006 | 2019-06-26 |
| 1376007765 | Abq Ep, LLC | Emergency Medicine | 9310 Coors Blvd Nw, Albuquerque, NM 87114-4006 | 2019-01-30 |
| 1174016455 | Claire Marie Pultz | Emergency Medicine | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2018-06-11 |
| Find all providers with the same taxonomy | ||||
| City | LOS ALAMOS |
| Zip Code | 87544 |
Please comment or provide details below to improve the information on PHC-LOS ALAMOS INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.