NPIMap

Organization Active NPI

Presbyterian Medical Services

Doing business as Teen Health Center Santa Fe High School

  • Federally Qualified Health Center (FQHC)
  • Santa Fe, NM
National Provider Identifier
1003984089
Registry record updated Jan 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
PRESBYTERIAN MEDICAL SERVICES
Doing business as
Teen Health Center Santa Fe High School
Practice address
2100 Yucca St
Santa Fe High School
Santa Fe, NM 87505-5456
Phone
(505) 467-2439
Fax
(505) 467-2989
NPI assigned
Nov 30, 2006
Last updated
Jan 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2021

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

Authorized official

Name
Doug Smith
Title
Executive Vice President
Phone
(505) 982-5565

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Student Health Clinic/Center 261QS1000X CL00007506 NM

Addresses

Primary practice location

2100 Yucca St
Santa Fe High School
Santa Fe, NM 87505-5456

Mailing address

PO Box 2267
Santa Fe, NM 87504-2267
Phone (505) 982-5565

Other names 1

  • Teen Health Center Santa Fe High School Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003984089. Details of each certification follow.

  • CCN 321899 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 321899

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SANTA FE HIGH TEEN HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 18, 2005
Last certification
Mar 18, 2005
Ownership / control type
For profit – corporation
Facility address
2100 Yucca Street
Santa Fe, NM 87505
Related CCNs
321861

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D1035516Presbyterian Medical Services Teen Health Center2100 Yucca Street, Santa Fe, NM 87505Certificate of waiverAug 14, 2026

National Provider Directory

National Provider Directory
Tax ID family
PMS Questa Health Cente70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners & affiliated clinicians

Practitioners 9

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": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610150400000",
    "number": "1003984089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2267",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875042267",
            "telephone_number": "505-982-5565",
            "fax_number": "505-992-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 YUCCA ST",
            "address_2": "SANTA FE HIGH SCHOOL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055456",
            "telephone_number": "505-467-2439",
            "fax_number": "505-467-2989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "505-982-5565"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "NM",
            "license": "CL00007506",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teen Health Center Santa Fe High School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Teen Health Center Santa Fe High School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

Verify at the official NPI Registry.