DR. JIMMIE R CHARLIE (NPI# 1366523722) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366523722 |
| Entity Type | Individual |
| Full Name | DR. JIMMIE R CHARLIE |
| Credential | M.D. |
| Practice Address |
85 West Highway 22 Santo Domingo NM 87502-0340 |
| Mailing Address |
Po Box 340 Santo Domingo Pueblo NM 87052-0340 |
| Practice Telephone | 5054653060 |
| Practice Fax Number | 5054653060 |
| Mailing Telephone | 5054653060 |
| Mailing Fax Number | 5058676527 |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2016-09-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 20020019 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 85534862 | 05 |
| Street Address |
85 WEST HIGHWAY 22 |
| City | SANTO DOMINGO |
| State | NM |
| Zip Code | 87502-0340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164531950 | Jonathan Neil Trujillo | Pharmacist | 85 West Highway 22, Santo Domingo Health Center, Santo Domingo, NM 87052 | 2006-08-29 |
| 1811336381 | Cynthia Eileen Guzman | Psychologist | 85 West Highway 22, Santo Domingo, NM 87052 | 2013-06-18 |
| 1205092160 | John M Robertson | Internal Medicine | 85 West Highway 22, Santo Domingo, NM 87052-0340 | 2008-07-31 |
| 1508061193 | David Martinez | General Acute Care Hospital | 85 West Highway 22, Santo Domingo, NM 87052 | 2007-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255479309 | Chad Smelser | Pediatrics | 1190 St Francis Dr, Santa Fe, NM 87502 | 2007-02-01 |
| 1639289416 | Felicia Abeyta | Physical Therapist | 786a N St Francis Dr, Santa Fe, NM 87502 | 2006-08-30 |
| 1629066634 | Jessica M Brewster | Dentist | 1035 Alto Street, Santa Fe, NM 87502-2406 | 2005-10-12 |
| 1679641260 | Judith G. Jenkins | Dentist | 1035 Alto Street, Santa Fe, NM 87502-5395 | 2006-12-01 |
| 1639382542 | Nmdoh Family Infant Toddler Program | Community/Behavioral Health | 1190 Saint Francis Drive, Santa Fe, NM 87502-6110 | 2007-05-07 |
| 1033241310 | Tierney Anne Murphy | Family Medicine | 1190 S Saint Francis Dr, Runnels Building, N1305, Santa Fe, NM 87502-6110 | 2007-03-12 |
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1962001024 | Laguna Healthcare Corp | Family Medicine | 6 Basswood Rd, Paraje, NM 87007 | 2020-10-20 |
| 1063027761 | Compassion Care Clinic PC | Family Medicine | 600 Hwy 195, Ste A, Elephant Butte, NM 87935 | 2020-09-10 |
| 1063027696 | Comprehensive Gastrostomy Tube Cares, LLC | Family Medicine | 8100 Wyoming Blvd Ne Ste M4-701, Albuquerque, NM 87113-1946 | 2020-09-10 |
| 1700498748 | Sandia View Family Medicine, PC | Family Medicine | 4200 Meadowlark Ln Se Ste 2, Rio Rancho, NM 87124-1050 | 2020-08-20 |
| 1740898428 | Dr. Maggie Wilson, PC | Family Medicine | 717 Encino Pl Ne Ste 5, Albuquerque, NM 87102-2624 | 2020-07-17 |
| 1861028102 | Lindsay Sue Cerrone | Family Medicine | 6 Kalma Ln, Edgewood, NM 87015-9593 | 2020-03-18 |
| 1053947408 | Optimal Wellness Journey | Family Medicine | 3231 Caminito San Lucas, Santa Fe, NM 87507-0443 | 2020-03-18 |
| 1831734813 | Leandra Lee Medina | Family Medicine | 7050 Barstow St Ne Ste B, Albuquerque, NM 87111-1056 | 2019-11-13 |
| 1053952473 | Healthnm, LLC | Family Medicine | 3612 Plano Vista Rd Ne, Rio Rancho, NM 87124-4182 | 2019-10-07 |
| 1497301824 | Gila Regional Medical Center | Family Medicine | 901 S. Gold Avenue, Deming, NM 88030 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
| City | SANTO DOMINGO |
| Zip Code | 87502 |
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| 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.