CIBOLA GENERAL HOSPITAL CORPORATION (NPI# 1780677039) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780677039 |
| Entity Type | Organization |
| Organization Name | CIBOLA GENERAL HOSPITAL CORPORATION |
| Other Organization Name | CIBOLA GENERAL HOSPITAL |
| Practice Address |
1016 E Roosevelt Ave Grants NM 87020-2118 |
| Practice Telephone | 5052875300 |
| Practice Fax Number | 5052875309 |
| Mailing Telephone | 5052875300 |
| Mailing Fax Number | 5052875309 |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2020-08-18 |
| Authorized Official Name | DONNA ROJAS (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 5052875202 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
6079 | NM | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 000729 | 05 | |
| NM | MEDICARE ID - UNSPECIFIED | 321308 | 01 |
| Other Name | Type Code |
|---|---|
| Cibola General Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457675266 | Cibola General Hospital Corporation | Family Medicine | 1423 E Roosevelt Ave, Grants, NM 87020-2245 | 2010-03-23 |
| 1003444647 | Cibola General Hospital Corporation | Surgery | 1208 Bonita St, Grants, NM 87020-2234 | 2020-03-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CIBOLA GENERAL HOSPITAL CORPORATION | 1016 Roosevelt Ave, Grants, NM 87020-2118 |
| Street Address |
1016 E ROOSEVELT AVE |
| City | GRANTS |
| State | NM |
| Zip Code | 87020-2118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770047441 | Fedko Emergency Physicians New Mexico LLC | Emergency Medicine | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2019-01-28 |
| 1023593472 | Megan Patricia Greteman | Physician Assistant | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2018-10-02 |
| 1669954053 | Angela Marie Montgomery | Nurse Practitioner | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2018-08-31 |
| 1558711846 | Alfredo Nevarez | Family Medicine | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2016-06-16 |
| 1093024275 | Cibola General Hospital Phcy | Pharmacy | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2010-10-05 |
| 1629122973 | Merton Olai Johnson | Nurse Anesthetist, Certified Registered | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2007-01-23 |
| 1699885517 | Vista Emergency Physicians | Emergency Medicine | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2006-08-30 |
| 1588694871 | Edward S. Sanshu Certified & Reg | Nurse Anesthetist, Certified Registered | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2006-07-03 |
| 1134155443 | Edward S Sanshu | Nurse Anesthetist, Certified Registered | 1016 E Roosevelt Ave, Grants, NM 87020-2118 | 2006-06-26 |
| 1265489389 | Chander S Bhatia | Emergency Medicine | 1016 E Roosevelt Ave, Emergency Department, Grants, NM 87020-2118 | 2006-05-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104453836 | Tiffany Shell Flippen | Counselor | 1016 E. Roosevelt Ave., Grants, NM 87020 | 2020-03-24 |
| 1295382265 | Janell Marie Villalobos | Registered Nurse | 813 Mesa Blvd., Grants, NM 87020 | 2019-08-23 |
| 1396243390 | Las Brisas Enterprises, LLC | Clinic/Center | 1209 Bonita Ave Suite A, Grants, NM 87020 | 2018-01-25 |
| 1407386014 | Wilma Beverly White | Occupational Therapy Assistant | 200 Adams, Grants, NM 87020 | 2017-06-15 |
| 1063840551 | Patricia Thompson | Nurse Practitioner | 2111 Lobo Canyon Rd, Grants, NM 87020 | 2013-10-22 |
| 1063778512 | Adobe Foot and Ankle Specialists, P.C. | Podiatrist | 765 E. Roosevelt Ave., Grants, NM 87020 | 2012-04-10 |
| 1841588506 | Saint Mary Nonemergency Medical Transportatio | Non-emergency Medical Transport (VAN) | 1325 Saddlehorn Trail, Grants, NM 87020 | 2011-07-15 |
| 1801129416 | Tammy L. White | Social Worker | 2595 West Highway 66, Grants, NM 87020 | 2009-09-14 |
| 1720236524 | Martha Abeyta | Nurse Practitioner | 1210 Mt. Taylor Ave, Grants, NM 87020 | 2008-09-04 |
| 1780869255 | Lou G. Mazon-vigil | Homeopath | 1300 Del Norte Blvd, Grants, NM 87020 | 2008-01-03 |
| Find all providers in zip 87020 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
Please comment or provide details below to improve the information on CIBOLA GENERAL HOSPITAL CORPORATION.
| 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.