NPIMap

Organization Active NPI

Lovelace Health System LLC

Doing business as Lovelace Outpatient Rehabilitation Santa Fe

  • Rehabilitation Practitioner
  • Santa Fe, NM
National Provider Identifier
1023325842
Registry record updated Feb 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
APPLIED FOR Issued in NM
Legal business name
LOVELACE HEALTH SYSTEM LLC
Doing business as
Lovelace Outpatient Rehabilitation Santa Fe
Practice address
1692 Hospital Dr
Suite 202
Santa Fe, NM 87505-4754
Phone
(505) 982-6399
Fax
(505) 727-9404
NPI assigned
Sep 1, 2010
Last updated
Feb 22, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
ARDENT LEGACY HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 22, 2022

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

Authorized official

Name
Mr. Stephen C Petrovich
Title
SVP
Phone
(615) 296-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X APPLIED FOR NM Primary

Addresses

Primary practice location

1692 Hospital Dr
Suite 202
Santa Fe, NM 87505-4754

Mailing address

1692 Hospital Dr
Suite 202
Santa Fe, NM 87505-4754
Phone (505) 982-6399

Other names 1

  • Lovelace Outpatient Rehabilitation Santa Fe Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000397 NM Part B Supplier - Clinic/Group Practice 9739099326 Receives reassigned benefits from 65 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Roswell, NM; Albuquerque, NM

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1023325842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 HOSPITAL DR",
            "address_2": "SUITE 202",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054754",
            "telephone_number": "505-982-6399",
            "fax_number": "505-727-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1692 HOSPITAL DR",
            "address_2": "SUITE 202",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054754",
            "telephone_number": "505-982-6399",
            "fax_number": "505-727-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVELACE HEALTH SYSTEM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARDENT LEGACY HOLDINGS, LLC",
        "enumeration_date": "2010-09-01",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "615-296-3000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NM",
            "license": "APPLIED FOR",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lovelace Outpatient Rehabilitation Santa Fe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lovelace Outpatient Rehabilitation Santa Fe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.