PHC-Los Alamos Inc

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

Legal business name

PHC-LOS ALAMOS INC

Practice address

3917 West Rd
Los Alamos, NM 87544-2275

Phone

(505) 662-3452

NPI assigned

Mar 5, 2007

Last updated

Apr 25, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Terrance Dillon

Title

Assistant Secretary

Phone

(502) 596-7220

Specialties & licenses 6

Addresses

Other identifiers 1

Tax ID family

PHC- Los Alamos Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• PHC- Los Alamos Inc

  dba Los Alamos Medical Center Outpatient Pharmacy

  • Clinic Pharmacy
  • Los Alamos, NM
  • NPI 1821130626
  NPD tax ID
• PHC-Los Alamos Inc

  dba Los Alamos Medical Center

  • Rural Acute Care Hospital
  • Los Alamos, NM
  • NPI 1285701623
  NPD tax ID

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1023147097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SEVEN SPRINGS WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274536",
            "telephone_number": "615-920-7000",
            "fax_number": "615-920-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3917 WEST RD",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875442275",
            "telephone_number": "505-662-3452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC-LOS ALAMOS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "DILLON",
        "authorized_official_first_name": "TERRANCE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "502-596-7220"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "96651067",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Pasqualoni
• Anne Elizabeth Peick, NP
• Elisabeth Scherf Perry, PH.D.
• Melissa Jane Petty, NP
• PHC- Los Alamos Inc (Los Alamos Medical Center Outpatient Pharmacy)
• PHC-Los Alamos Inc (Los Alamos Medical Center - swing bed unit)
• PHC-Los Alamos Inc (Los Alamos Medical Center)
• Physical Therapy Plus Inc
• Petra Pirc, MSPT
• Tina Lynn Platte

• Emergency Medical Services (Emergency Medicine) Physician in Los Alamos, NM
• Providers in Los Alamos, NM by specialty
• Emergency Medical Services (Emergency Medicine) Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.