Active NPI
Roswell Clinic Corp
Doing business as Mesa Medical
- Durable Medical Equipment & Medical Supplies
- Roswell, NM
National Provider Identifier
1043423379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- 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, 2008
- Organization subpart
- Yes
- Parent organization
- ROSWELL CLINIC CORP
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
-
dba Family Practice Wound & Ostomy Care Center
- Durable Medical Equipment & Medical Supplies
- Roswell, NM
- NPI 1285804716
O20031111000799
-
dba Sierra Orthopedics
- Durable Medical Equipment & Medical Supplies
- Roswell, NM
- NPI 1356553002
O20031111000799
-
dba Eastern Plains Urology
- Durable Medical Equipment & Medical Supplies
- Roswell, NM
- NPI 1396958633
O20031111000799
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
- 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
- Sierra Roosevelt
- Yaweh Rosales, PT
- Rosewell Senior Living, LLC (La Villa Assisted Living and Memory Care Community)
- Phalla Ross
- Stasha Ross
- Roswell Clinic Corp (Family Practice Wound & Ostomy Care Center)
- Roswell Clinic Corp (Sierra Orthopedics)
- Roswell Clinic Corp (Eastern Plains Urology)
- Roswell Clinic Corp (Ponderossa Medical Associates)
- Roswell Clinic Corp (Roswell Family Medicine and Walk-In Clinic)
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.