PRN MEDICAL (NPI# 1982826079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982826079 |
| Entity Type | Organization |
| Organization Name | PRN MEDICAL |
| Practice Address |
1717 W 2nd St Suite 115 Roswell NM 88201-2000 |
| Practice Telephone | 5056275700 |
| Practice Fax Number | 5056279419 |
| Mailing Telephone | 5056275700 |
| Mailing Fax Number | 5056279419 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2010-11-23 |
| NPI Deactivation Date | 11/26/2007 |
| NPI Reactivation Date | 2010-10-28 |
| Authorized Official Name | DR. GABRIELE STILLER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5056279350 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | B8576 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PRN MEDICAL AND LEGAL CONSULTING SERVICES, INC. | 55 Highland Avenue, Fall River, MA 02720 |
| New York State Corporations | PRN MEDICAL REVIEWS INC. | 9946 Coronado Lake Drive, Boynton Beach, Florida 33437 |
| System for Award Management (SAM) Entities | PRN MEDICAL SERVICES | 4500 Rogers Ave, Fort Smith, AR 72903-3147 |
| Virginia Business Entities | PRN Medical Services LLC | 20333 N 19th Ave Ste 101, Phoenix, Arizona 85027-3627 |
| Iowa Business Entities | PRN MEDICAL SERVICES, LLC | 20333 N 19th Ave Ste 101, Phoenix, AZ 85027 |
| Colorado Business Entities | PRN Medical Services, LLC | 20333 N. 19th Avenue, Suite 101, Phoenix, AZ 85027 |
| Washington State Corporations | PRN MEDICAL SERVICES, LLC | 20333 N 19th Ave, Ste 101, Phoenix, AZ 85027-3602 |
| Vermont Business Registrations | PRN MEDICAL SERVICES, LLC | 2311 W. Utopia Road, Phoenix, AZ 85027 |
| Connecticut Business Registrations | PRN MEDICAL SERVICES, LLC | 2311 W. Utopia Road, Phoenix, AZ 85027 |
| Indiana Business Entities | PRN MEDICAL SERVICES, LLC | 2311 W Utopia Rd, Phoenix, AZ 85027 |
| Street Address |
1717 W 2ND ST SUITE 115 |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201-2000 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518938315 | Michael A Fraga | Clinical Neuropsychologist | 1717 W 2nd St, Roswell, NM 88201-2000 | 2006-01-30 |
| 1265807192 | Choices Center for Independent Living Inc. | Case Management | 1717 W 2nd St, Suite 115, Roswell, NM 88201-2000 | 2015-12-03 |
| 1669750824 | Tammy Lynn Ray | Homeopath | 1717 W 2nd St, Suite 116, Roswell, NM 88201-2000 | 2011-07-21 |
| 1801030093 | Mcguire Wound & Ostomy Center PC | Nurse Practitioner | 1717 W 2nd St, Suite 101, Roswell, NM 88201-2000 | 2009-05-01 |
| 1871733659 | Gretta Dickman | Massage Therapist | 1717 W 2nd St, Suite 115, Roswell, NM 88201-2000 | 2009-03-06 |
| 1548400559 | Allergy & Asthma Clinic, LLC | Allergy & Immunology | 1717 W 2nd St, Suite 219, Roswell, NM 88201-2000 | 2009-03-03 |
| 1316135957 | Sleep Diagnostic Centers of New | Clinic/Center | 1717 W 2nd St, Suite 172, Roswell, NM 88201-2000 | 2007-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
| Find all providers in zip 88201 | ||||
| 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 |
|---|---|---|---|---|
| 1114543196 | Injury Md LLC | Family Medicine | 245 Steeple Point Dr, Roswell, GA 30076-5521 | 2020-06-24 |
| 1073070991 | Hip Medical Georgia,llc | Family Medicine | 11660 Alpharetta Hwy Ste 285, Roswell, GA 30076-3876 | 2019-02-27 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1801261714 | Arnett Medical, LLC | Family Medicine | 1915 N Atkinson Ave, Roswell, NM 88201-7600 | 2015-12-02 |
| 1265792022 | Brandon C Cometti | Family Medicine | 300 W Country Club Rd Ste 210, Roswell, NM 88201-5240 | 2012-05-25 |
| 1790095974 | Lawrence Joseph Barbour Sr. | Family Medicine | 803 Sherrill Ln, Roswell, NM 88201-3469 | 2010-10-20 |
| 1699099390 | New Mexico Medical Surgical Hospital LLC | Family Medicine | 2335 N Main St, Roswell, NM 88201-6452 | 2010-03-24 |
| 1700016284 | Jeremy D Boyd | Family Medicine | 9420 Willeo Rd Ste 206, Roswell, GA 30075-6773 | 2009-07-20 |
| 1497990220 | David Ludvig Hammer | Family Medicine | 10535 Turner Rd, Roswell, GA 30076-2438 | 2008-12-08 |
| 1578728309 | Lakshmi Gopireddy | Family Medicine | 3000 Hospital Blvd Fl 2, Roswell, GA 30076 | 2008-07-21 |
| Find all providers in ROSWELL | ||||
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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.