City of Mountainair

Primary specialty

AmbulanceTaxonomy code 341600000X

License

14303 Issued in NM

Legal business name

CITY OF MOUNTAINAIR

Doing business as

Mountainair Fire & Rescue

Practice address

105 Acoma
Mountainair, NM 87036-0591

Phone

(505) 847-2321

Fax

(505) 847-0421

NPI assigned

Apr 13, 2007

Last updated

Apr 16, 2018By 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

Mr. Sam E Blackshear

Title

Ambulance Chief

Phone

(505) 847-2316

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mountainair Fire & Rescue Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523836800000",
    "number": "1053535450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 OSUNA RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094467",
            "telephone_number": "505-226-1800",
            "fax_number": "505-247-2482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ACOMA",
            "city": "MOUNTAINAIR",
            "state": "NM",
            "postal_code": "870360591",
            "telephone_number": "505-847-2321",
            "fax_number": "505-847-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF MOUNTAINAIR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2018-04-16",
        "status": "A",
        "authorized_official_last_name": "BLACKSHEAR",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "AMBULANCE CHIEF",
        "authorized_official_telephone_number": "505-847-2316",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NM",
            "license": "14303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R2809",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountainair Fire & Rescue",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mountainair Fire & Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lori Alison Autrey, RPH
• Susan Kay Banks, CNP
• Marie Justine Cadieux, PHARMD
• Tanna M Corral, LMSW
• Laurie A Engelhard
• Frances Roggen, P.T., P.a. (In Motion)
• Michael Archie Hays, M.A.
• Mountainair Meds & More, LLC

• Ambulance in Mountainair, NM
• Providers in Mountainair, NM by specialty
• Ambulance in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.