Aztec Urgent Care, LLC
Organization Active NPI Urgent Care Clinic/Center · Aztec, NM
NPI 1063741163 · NPPES record last updated Jun 17, 2026
Key facts
- NPI
- 1063741163
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- AZTEC URGENT CARE, LLC
- Practice address
- 422 N Main Ave
Aztec, NM 87410-1928 - Phone
- (970) 505-2100
- Fax
- (505) 334-7759
- NPI assigned
- Dec 18, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Bryan Vincent
- Title
- President
- Phone
- (970) 505-2100
Member of 1
Practitioners 29
-
Douglas Accountius, RN, MBA, AG-ACNP-BC
-
Anysha Gustafson, FNP-C
-
John Simmons, FNP-C
-
Erin Tinker, NP
-
Eli S Mauksch, DNP
-
Benjamin Donald Reetz, PA-C
-
Mary Alice Rios, PA-C
-
Leah M Schlierf, NP
-
Milagros Mirdo, CNP
-
Patrick Ely, PA
-
Amanda Grace Kiessel, PA-C
-
Sara Elizabeth Shively, PA-C
-
Christopher A Stewart, PA-C
-
Jenny Hargrove, M.D.
-
Jesse Alexander Keele, APRN-CNP
-
Shaina Nawrocki, CFNP
-
Jessica Martinez, MPAS
-
Nicholas M Armano, P.A.
-
Nicole Marie Oury, M.D.
-
Shawnee Bradley, FNP-BC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 32D2011233 | Aztec Urgent Care, Dba Four Corners Urgent Care | Compliance | Jan 5, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101006000701 | NM | Part B Supplier - Clinic/Group Practice | 7810189016 |
Receives reassigned benefits from 24 practitioners Practice locations: Aztec, NM; Farmington, NM |
| O20140207001282 | NM | DME Supplier - Physician - General Practice | 7810189016 | Practice locations: Aztec, NM |
National Provider Directory
Locations
422 N Main Ave
Aztec, NM 87410
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
422 N Main Ave
Aztec, NM 87410-1928
Mailing address
2577 Main Ave
Durango, CO 81301-5919
Phone (970) 247-8382
Other practice location 1
2930 E Main St
Farmington, NM 87402-7624
Phone (970) 505-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 69824762 | Medicaid | NM |
Other names
- Four Corners Urgent Care, LLC
Other providers in Aztec, NM
- Aztec Family Practice PA
- Aztec Healthcare LLC
- Aztec Municipal School District
- Aztec Municipal Schools
- Aztec Spa and Wellness
- Rebekah Bainter
- Elizabeth Bannowsky
- William R Barkman
- Dana Kay Bearden
- Stacey Marie Bentley
All providers in Aztec, NM · Urgent Care Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.