KEWA PUEBLO HEALTH CORPORATION (NPI# 1811274061) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811274061 |
| Entity Type | Organization |
| Organization Name | KEWA PUEBLO HEALTH CORPORATION |
| Other Organization Name | SANTO DOMINGO HEALTH CENTER |
| Practice Address |
85 W Highway 22 Santo Domingo NM 87052-0340 |
| Mailing Address |
Po Box 559 Santo Domingo Pueblo NM 87052-0559 |
| Practice Telephone | 5054653060 |
| Practice Fax Number | 5054651191 |
| Mailing Telephone | 5054653060 |
| Mailing Fax Number | 5054651191 |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |
| Authorized Official Name | VANESSA DIANA VIGIL (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 5054653060 |
| Is Organization Subpart | Y |
| Parent Organization Name | KEWA PUEBLO HEALTH CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Santo Domingo Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467739888 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo Pueblo, NM 87052-0559 | 2011-11-14 |
| 1336659077 | Kewa Pueblo Health Corporation | Community/Behavioral Health | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2017-10-09 |
| 1679842983 | Kewa Pueblo Health Corporation | Non-emergency Medical Transport (VAN) | 85 W Highway 22, Santo Domingo, NM 87052 | 2011-12-16 |
| 1902183155 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1194002345 | Kewa Pueblo Health Corporation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1003193251 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1558648709 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1467739615 | Kewa Pueblo Health Corporation | Optometrist | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| Street Address |
85 W HIGHWAY 22 |
| City | SANTO DOMINGO |
| State | NM |
| Zip Code | 87052-0340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679842983 | Kewa Pueblo Health Corporation | Non-emergency Medical Transport (VAN) | 85 W Highway 22, Santo Domingo, NM 87052 | 2011-12-16 |
| 1902183155 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1194002345 | Kewa Pueblo Health Corporation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1003193251 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1558648709 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1467739615 | Kewa Pueblo Health Corporation | Optometrist | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902353972 | Karin Luzzi | Registered Nurse | 100 Highway 22 W, Santo Domingo, NM 87052 | 2016-09-07 |
| 1043676273 | Kyle Maestas | Physician Assistant | 85 West Hwy 22, Santo Domingo, NM 87052 | 2016-01-04 |
| 1639579352 | Cynthia Brooks | Registered Nurse | 85 West Highway 22 Santo Domingo Health Center, Santo Domingo, NM 87052 | 2014-08-29 |
| 1720335219 | Samantha Nicole Torres | Pharmacist | 85 W Hwy 22, Santo Domingo, NM 87052 | 2012-08-14 |
| 1780835504 | Roger L Leonard | Clinic/Center | #85 West Hwy 22, Santo Domingo, NM 87052 | 2008-10-10 |
| 1679766489 | Santo Domingo Tribe | Ambulance | #1 Tesuque St., Ems Headquarters, Santo Domingo Pueblo, NM 87052 | 2007-08-24 |
| 1326165994 | Santa Domingo Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 340 San Ildefonso St, Santa Domingo, NM 87052 | 2007-03-26 |
| 1467509612 | Andrea Heeter | Specialist/Technologist | Santo Domingo Health Center, 85 Hwy 22, Santo Domingo, NM 87052 | 2007-01-03 |
| 1164531950 | Jonathan Neil Trujillo | Pharmacist | 85 West Highway 22, Santo Domingo Health Center, Santo Domingo, NM 87052 | 2006-08-29 |
| 1053920520 | John Patirck Pagett | Registered Nurse | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2020-07-30 |
| Find all providers in zip 87052 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932727088 | Disabled Veterans Reference Labs Inc | Clinical Medical Laboratory | 5400 Gibson Blvd Se Ste 20, Albuquerque, NM 87108-5182 | 2020-07-06 |
| 1407411762 | Ron Smock | Clinical Medical Laboratory | 4213 Montgomery Blvd Ne, Albuquerque, NM 87109-1103 | 2019-05-02 |
| 1780059717 | Southwest Labs LLC | Clinical Medical Laboratory | 4261 Balloon Park Rd Ne, Albuquerque, NM 87109-5802 | 2015-12-02 |
| 1669858700 | Nex Step, Inc. | Clinical Medical Laboratory | 518 Old Santa Fe Trl, Suite 1, Pmb 220, Santa Fe, NM 87505-0398 | 2015-07-30 |
| 1225424567 | Recovery Services of New Mexico | Clinical Medical Laboratory | 5659 Jefferson St Ne, Suite E, Albuquerque, NM 87109-3458 | 2015-04-14 |
| 1255725339 | Ann Owens Tafoya | Clinical Medical Laboratory | 1301 Kentucky St Se, Albuquerque, NM 87108-5108 | 2015-03-26 |
| 1740615855 | Elizabeth Amanda Stenger | Clinical Medical Laboratory | 10444 Calle Avila Nw, Albuquerque, NM 87114-1804 | 2013-09-08 |
| 1821381773 | Alethea Laboratories Inc | Clinical Medical Laboratory | 410 E. Foster Road, Las Cruces, NM 88005-3209 | 2011-05-25 |
| 1083946222 | Metwest Inc | Clinical Medical Laboratory | 1121 Mall Dr, Las Cruces, NM 88011-8102 | 2010-02-12 |
| 1467783753 | Matrix Genomics, Inc. | Clinical Medical Laboratory | 3900 Paseo Del Sol, Santa Fe, NM 87507-4072 | 2010-01-26 |
| Find all providers with the same taxonomy | ||||
| City | SANTO DOMINGO |
| Zip Code | 87052 |
Please comment or provide details below to improve the information on KEWA PUEBLO HEALTH 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.