Tedomer LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

TEDOMER LLC

Practice address

3720 Church Rock Rd
Gallup, NM 87301-4572

Phone

(505) 722-2261

Fax

(505) 722-4732

NPI assigned

Dec 28, 2007

Last updated

Jan 3, 2008By 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

Timothy NMN Domer, MDNPI 1942389770

Title

Medical Director

Phone

(505) 783-4045

Specialties & licenses 3

Addresses

Locations

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.

• Timothy Domer, M.D.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Tucson, AZ
  • NPI 1942389770

  Geriatric Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1033394861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 CHURCH ROCK RD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014572",
            "telephone_number": "505-722-2261",
            "fax_number": "505-722-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 CHURCH ROCK RD",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014572",
            "telephone_number": "505-722-2261",
            "fax_number": "505-722-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEDOMER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-28",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "DOMER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "NMN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "505-783-4045",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor G Wright PC (Innovation Medical Group)
• Amanda Taylor, RN
• Anne Lauren Taylor, DO
• Capwell Edwin Taylor, MD
• Stella Taylor, RN
• Joshua Telfer, DPT
• Bruce D. Tempest, MD
• Peter Tempest, MD
• Cassandra Tenney
• Elizabeth Terrill, LPCC

• Internal Medicine Physician in Gallup, NM
• Providers in Gallup, NM by specialty
• Internal Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; 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.