Individual provider Active NPI

George Lee Payne, M.D.

  • Family Medicine Physician
  • Farmington, NM
National Provider Identifier
1023033461
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
99-99 Issued in NM
Practice address
622 W Maple St
Suite B
Farmington, NM 87401-6590
Phone
(505) 327-4867
Fax
(505) 327-5355
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 99-99 NM Primary

Addresses

Primary practice location

622 W Maple St
Suite B
Farmington, NM 87401-6590

Mailing address

622 W Maple St
Suite B
Farmington, NM 87401-6590
Phone (505) 327-4867

Other identifiers 1

IdentifierTypeStateIssuer
Z7224MedicaidNM

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Endoscopy LLC PastSince Feb 21, 2007 Accepting new patients
San Juan Health Services, LLC PastSince Apr 1, 2012 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391040000000",
    "number": "1023033461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 W MAPLE ST",
            "address_2": "SUITE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016590",
            "telephone_number": "505-327-4867",
            "fax_number": "505-327-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 W MAPLE ST",
            "address_2": "SUITE B",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016590",
            "telephone_number": "505-327-4867",
            "fax_number": "505-327-5355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "GEORGE",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "99-99",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Z7224",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.