VIA CHRISTI MEDICAL CLINIC, INC. (NPI# 1730131848) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730131848 |
| Entity Type | Organization |
| Organization Name | VIA CHRISTI MEDICAL CLINIC, INC. |
| Practice Address |
100 E Manana Blvd Unit 1 Clovis NM 88101-3503 |
| Mailing Address |
Po Box 520 Clovis NM 88102-0520 |
| Practice Telephone | 5757422500 |
| Practice Fax Number | 5757429878 |
| Mailing Telephone | 5757422500 |
| Mailing Fax Number | 5757429878 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2008-11-12 |
| Authorized Official Name | DR. HARRY KYLE SHEETS (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 5757422500 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2001-306 | NM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | RAILROAD MEDICARE PIN | P00119862 | 01 |
| NM | 80739237 | 05 |
| Street Address |
100 E MANANA BLVD UNIT 1 |
| City | CLOVIS |
| State | NM |
| Zip Code | 88101-3503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881090066 | Melissa Vazquez | Social Worker | 100 E Manana Blvd, Clovis, NM 88101-3503 | 2014-11-14 |
| 1609945328 | John Ansel Cruz Jimenez | Physical Therapist | 100 E Manana Blvd, Unit 1, Clovis, NM 88101-3503 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134748692 | Patrick James Scollon | Military Health Care Provider | 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 | 2020-04-14 |
| 1285274878 | Keishla Cota | Physical Therapist | 100 East Manana Blvd, Unit 1, Clovis, NM 88101 | 2020-01-10 |
| 1659927283 | Ndeye Ndour | Nurse Anesthetist, Certified Registered | 2100 N M.l.k. Jr Blvd, Clovis, NM 88101 | 2019-08-09 |
| 1679132468 | Justine Nicole Nunez | Nurse Practitioner | 2301 North Doctor Martin Luther King Boulevard, Clovis, NM 88101 | 2019-06-06 |
| 1518453521 | Moore Psychological Services, Pllc | Social Worker | 1908 West 21st Street, Clovis, NM 88101 | 2018-07-03 |
| 1912494006 | Raesha Russell | Behavior Technician | 214 West 9th St, Clovis, NM 88101 | 2018-04-16 |
| 1013425800 | Vanessa Yardley | Registered Nurse | 2100 N. Martin Luther King Jr. Blvd., Clovis, NM 88101 | 2018-01-16 |
| 1699204230 | Olivia Garcia | Technician, Other | 1100 W 21st Street, Clovis, NM 88101 | 2017-06-07 |
| 1578006250 | Mary Ellen Gray | Technician, Other | 9408 B Vermont Court, Clovis, NM 88101 | 2016-11-29 |
| 1205296977 | Malaney Harmon | Behavioral Analyst | 2700 E 7th St., Clovis, NM 88101 | 2016-02-24 |
| Find all providers in zip 88101 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225660871 | Mercy Seyi Ayodele | Family Medicine | 55 Shaw Ave Ste 207, Clovis, CA 93612-3819 | 2020-02-11 |
| 1932671005 | Jennifer Lynn Marmolejo | Family Medicine | 2552 Richert Ave, Clovis, CA 93611-6014 | 2018-12-29 |
| 1396210563 | Green Sports Medicine Inc | Family Medicine | 2021 Herndon Ave Ste 201, Clovis, CA 93611-6101 | 2018-10-03 |
| 1023429412 | Nadia Javaid | Family Medicine | 2006 Shaw Ave Ste 101, Clovis, CA 93611-4192 | 2014-05-19 |
| 1821371022 | Erick Joseph Green Jr. | Family Medicine | 2021 Herndon Ave # 101, Clovis, CA 93611-6101 | 2011-09-23 |
| 1760667133 | Larry Lowry | Family Medicine | 208 Sandzen Dr, Clovis, NM 88101-2310 | 2008-01-04 |
| 1265620728 | Gurdaver Singh Dhaliwal | Family Medicine | 1555 Shaw Ave, Ste 101, Clovis, CA 93611-4096 | 2007-10-10 |
| 1225250087 | G&j Roth Prof Corp. | Family Medicine | 255 W Bullard Ave Ste 102, Clovis, CA 93612-0861 | 2007-05-02 |
| 1023231057 | Meenakshi Dhingra | Family Medicine | 2740 Herndon Ave, Clovis, CA 93611-6813 | 2007-04-10 |
| 1588789788 | Anthony W Montana | Family Medicine | 688 Medical Center Dr E Ste 104, Clovis, CA 93611-6807 | 2007-03-20 |
| Find all providers in CLOVIS | ||||
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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.