Organization Active NPI

Roswell Clinic Corp

Doing business as Mesa Medical

  • Durable Medical Equipment & Medical Supplies
  • Roswell, NM
National Provider Identifier
1043423379
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
ROSWELL CLINIC CORP
Doing business as
Mesa Medical
Practice address
350 W Country Club Rd
Suite 201
Roswell, NM 88201-5205
Phone
(505) 622-1841
Fax
(505) 622-5316
NPI assigned
May 7, 2007
Last updated
Jul 15, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
ROSWELL CLINIC CORPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Debbie Brewer
Title
Director
Phone
(877) 892-9813

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

350 W Country Club Rd
Suite 201
Roswell, NM 88201-5205

Mailing address

330 Franklin Rd
#135A-599
Brentwood, TN 37027-3280

Other names 1

  • Mesa Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000799 NM Part B Supplier - Clinic/Group Practice 9436062759 Receives reassigned benefits from 69 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Roswell, NM; Hobbs, NM; Carlsbad, NM; Artesia, NM

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Part of
Roswell Clinic Corp

Locations

350 W Country Club Rd
Ste 201
Roswell, NM 88201
Phone (575) 622-1841

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1610/brand/1/csg/64/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1043423379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 FRANKLIN RD",
            "address_2": "#135A-599",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W COUNTRY CLUB RD",
            "address_2": "SUITE 201",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015205",
            "telephone_number": "505-622-1841",
            "fax_number": "505-622-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSWELL CLINIC CORP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROSWELL CLINIC CORP",
        "enumeration_date": "2007-05-07",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesa Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.