NPIMap

Organization Active NPI

Crossroads Community Health Clinic, Inc.

  • Acupuncturist
  • Taos, NM
National Provider Identifier
1003257924
Registry record updated Feb 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
1102 Issued in NM
Legal business name
CROSSROADS COMMUNITY HEALTH CLINIC, INC.
Practice address
1337 Gusdorf Rd
Suite O
Taos, NM 87571-6294
Phone
(575) 776-7806
NPI assigned
Jul 8, 2013
Last updated
Feb 17, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Lilly-Marie Maita Blecher, DOMNPI 1306090907
Title
Owner/Doctor
Phone
(575) 776-7806

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 1102 NM Primary
Family Medicine Physician 207Q00000X MD2011-0528 NM

Addresses

Primary practice location

1337 Gusdorf Rd
Suite O
Taos, NM 87571-6294

Mailing address

1337 Gusdorf Rd
Suite O
Taos, NM 87571-6294
Phone (575) 776-7806

Other identifiers 1

IdentifierTypeStateIssuer
1306090907OtherTYPE 1 NPI

National Provider Directory

National Provider Directory
Tax ID family
Crossroads Community Health Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487289600000",
    "number": "1003257924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1337 GUSDORF RD",
            "address_2": "SUITE O",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716294",
            "telephone_number": "575-776-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 GUSDORF RD",
            "address_2": "SUITE O",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "875716294",
            "telephone_number": "575-776-7806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS COMMUNITY HEALTH CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-08",
        "last_updated": "2017-02-17",
        "status": "A",
        "authorized_official_last_name": "BLECHER",
        "authorized_official_first_name": "LILLY-MARIE",
        "authorized_official_middle_name": "MAITA",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "575-776-7806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DOM"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "1102",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "MD2011-0528",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1 NPI",
            "identifier": "1306090907",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taos, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.