PRESBYTERIAN HEALTHCARE SERVICES (NPI# 1558347708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558347708 |
| Entity Type | Organization |
| Organization Name | PRESBYTERIAN HEALTHCARE SERVICES |
| Other Organization Name | LINCOLN COUNTY MEDICAL CENTER |
| Practice Address |
211 Sudderth Dr Ruidoso NM 88345-6002 |
| Mailing Address |
Po Box 26666 Provider Enrollment Albuquerque NM 87125-6666 |
| Practice Telephone | 5052577381 |
| Practice Fax Number | 5056304233 |
| Mailing Telephone | 5059235356 |
| Mailing Fax Number | 5059235354 |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2016-10-11 |
| Authorized Official Name | MR. BO BEAMES (VP REGIONAL OPERATIONS) |
| Authorized Official Telephone | 5059235339 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 3416L0300X |
Ambulance Specialization: Land Transport |
3199 | NM | Transportation Services |
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
3199 | NM | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | PART B | 2256807 | 01 |
| NM | 00521 | 05 |
| Other Name | Type Code |
|---|---|
| Lincoln County Medical Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730684853 | Presbyterian Healthcare Services | General Acute Care Hospital | 4801 Beckner Road, Santa Fe, NM 87507 | 2018-03-29 |
| 1942615570 | Presbyterian Healthcare Services | Pharmacy | 2401 W. 21st St, Clovis, NM 88101 | 2014-06-23 |
| 1215913470 | Presbyterian Healthcare Services | Emergency Medicine | 1100 Central Se, Albuquerque, NM 87106-4930 | 2005-12-20 |
| 1508842758 | Presbyterian Healthcare Services | Emergency Medicine | 615 Prospect Ave, Springer, NM 87747 | 2005-12-20 |
| 1053397497 | Presbyterian Healthcare Services | Medicare Defined Swing Bed Unit | 2200 W 21st St, Clovis, NM 88101-2011 | 2005-12-19 |
| 1336125764 | Presbyterian Healthcare Services | Emergency Medicine | 1202 Highway 60 Bldg E, Socorro, NM 87801-3914 | 2005-12-19 |
| 1972589307 | Presbyterian Healthcare Services | Emergency Medicine | 1202 Highway 60 Building E, Socorro, NM 87801 | 2005-12-19 |
| 1295710176 | Presbyterian Healthcare Services | Emergency Medicine | 2217 Dillon, Clovis, NM 88101-9454 | 2005-12-13 |
| 1235114125 | Presbyterian Healthcare Services | Emergency Medicine | 710 Avenue E, Carrizozo, NM 88301-0008 | 2005-12-13 |
| 1750366639 | Presbyterian Healthcare Services | Emergency Medicine | 2217 Dillon Rd, Clovis, NM 88101-9454 | 2005-12-13 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PRESBYTERIAN HEALTHCARE SERVICES | 9521 San Mateo Blvd Ne, Albuquerque, NM 87113-2237 |
| Colorado Business Entities | PRESBYTERIAN HEALTHCARE SERVICES | 5901 Harper N E, Albuquerque, NM 87109 |
| Street Address |
211 SUDDERTH DR |
| City | RUIDOSO |
| State | NM |
| Zip Code | 88345-6002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376545418 | Michael David Noltensmeyer | Nurse Anesthetist, Certified Registered | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2005-06-01 |
| 1144843491 | Presbyterian Healthcare Services | Medicare Defined Swing Bed Unit | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2020-05-21 |
| 1285253682 | Presbyterian Healthcare Services | Medicare Defined Swing Bed Unit | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2020-04-15 |
| 1144791435 | Michael Padilla | Pharmacist | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2018-12-11 |
| 1932659000 | Natalie Mcelhany | Nurse Practitioner | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2016-10-12 |
| 1184170185 | Francisco J Vargas Nava | Emergency Medicine | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2016-08-30 |
| 1396802864 | Presbyterian Healthcare Services | Emergency Medicine | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2007-01-03 |
| 1932209822 | Charles L Pfaff | Radiology | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2006-09-22 |
| 1124039235 | Lincoln County Radiology LLC | Radiology | 211 Sudderth Dr, Ruidoso, NM 88345 | 2006-08-11 |
| 1376552810 | Paul S Gulbas | Ophthalmology | 211 Sudderth Dr, Ruidoso, NM 88345-6002 | 2006-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295386373 | Angela Louise Chavez | Physical Therapy Assistant | 143 El Paseo Road, Ruidoso, NM 88345 | 2019-09-20 |
| 1740744630 | Aspen Creek Counseling, PC | Community/Behavioral Health | 212 Hidalgo St, Ruidoso, NM 88345 | 2019-01-25 |
| 1659729960 | Clinical Counseling, Rebekah Stephens LLC | Community/Behavioral Health | 105 Socorro Circle, Ruidoso, NM 88345 | 2016-05-26 |
| 1013288208 | Emily Jane Fleming | Counselor | 2904 Sudderth Dr, Ruidoso, NM 88345 | 2012-01-19 |
| 1376810572 | Ronald Lee Annala | Specialist | 101 Annala Lane, Ruidoso, NM 88345 | 2011-11-17 |
| 1801171731 | Felicia Yelena Fontenot | Dentist | 127 El Paso Road, Ruidoso, NM 88345 | 2011-10-11 |
| 1497072730 | Richard G Leveque | Counselor | 206 Porr Dirve, Ruidoso, NM 88345 | 2010-04-27 |
| 1871827899 | Delcia Maurice Gudgel | Counselor | 1400 Sudderth Drive, La Frontera, Ruidoso, NM 88345 | 2009-09-23 |
| 1740413541 | Yolanda Nelson | Case Manager/Care Coordinator | 208 Sudderth Dr, Ruidoso, NM 88345 | 2009-08-26 |
| 1164697280 | Elizabeth Urban Candelaria | Social Worker | 1400 Sudderth Dr., Ruidoso, NM 88345 | 2008-04-29 |
| Find all providers in zip 88345 | ||||
| Taxonomy Code | 282NC0060X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Critical Access |
| Definition to come. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780677039 | Cibola General Hospital Corporation | General Acute Care Hospital | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2005-08-23 |
| 1427051002 | Clayton Health Systems Inc | General Acute Care Hospital | 300 Wilson Street, Clayton, NM 88415-0489 | 2005-05-27 |
| 1922626407 | Gila Regional Medical Center | General Acute Care Hospital | 1313 E 32nd St, Silver City, NM 88061-7251 | 2020-07-10 |
| 1902338049 | Taos Health Systems, Inc., Holy Cross Hospital | General Acute Care Hospital | 1397 Weimer Rd, Taos, NM 87571-6253 | 2017-03-29 |
| 1891075446 | Deming Hospital Corporation | General Acute Care Hospital | 900 W Ash St, Deming, NM 88030-4000 | 2011-08-26 |
| 1780912352 | Nor-lea Hospital District | General Acute Care Hospital | 1600 N Main Ave, Lovington, NM 88260-2813 | 2009-11-19 |
| 1881630036 | Nor-lea Hospital District | General Acute Care Hospital | 1600 North Main, Lovington, NM 88260-2813 | 2006-06-22 |
| 1760446009 | Sierra Vista Hospital 69 | General Acute Care Hospital | 800 E 9th Ave, Truth Or Consequences, NM 87901-1954 | 2006-04-13 |
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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.