Individual provider Active NPI

Laura Waymire, M.D.

  • Neurology Physician
  • Farmington, NM
National Provider Identifier
1104141233
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD2014-0243 Issued in NM
Practice address
2300 E 30TH St Ste B-102
Farmington, NM 87401-8991
Phone
(505) 609-6790
Fax
(505) 599-4640
NPI assigned
Mar 31, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD2014-0243 NM Primary

Addresses

Primary practice location

2300 E 30TH St Ste B-102
Farmington, NM 87401-8991

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other identifiers 1

IdentifierTypeStateIssuer
63283786MedicaidNM

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL laura.waymire@sjmedical.cernerdirect.com Other SAN JUAN REGIONAL MEDICAL CENTER INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141024000980 NM Practitioner - Neurology 7113151275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of New Mexico School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
San Juan Regional Medical Center, Inc.Group PAC ID 4587559505, 233 clinicians

Practice addresses (Care Compare)

2300 E 30TH St
102 Sjrmc Neurology
Farmington, NM 87401-8991
Phone (505) 609-6790

Hospital & facility affiliations

  • San Juan Regional Medical Center Inc Hospital, Farmington, NM, CCN 320005

Merit-based Incentive Payment System (MIPS)

Final score
90.97 of 100Reported as group
Quality
79.73
Promoting interoperability
100
Improvement activities
40
Cost
78.87

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
San Juan Regional Medical Center Inc CurrentSince Jul 15, 2015 Accepting new patients
San Juan Regional Medical Center Inc Neurology CurrentSince Jul 15, 2015 Accepting new patients
San Juan Regional Medical Center Inc Current Accepting new patients
San Juan Regional Medical Center Inc Past Accepting new patients

Locations

120 Llano St
Aztec, NM 87410
Phone (505) 334-3404

407 S Schwartz Ave
Ste 101
Farmington, NM 87401
Phone (505) 609-6595

2300 E 30th St
Ste B-102
Farmington, NM 87401
Phone (505) 327-4044

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1104141233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST STE B-102",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874018991",
            "telephone_number": "505-609-6790",
            "fax_number": "505-599-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYMIRE",
        "first_name": "LAURA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-31",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NM",
            "license": "MD2014-0243",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63283786",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laura.waymire@sjmedical.cernerdirect.com",
            "affiliation": "Y",
            "affiliationName": "SAN JUAN REGIONAL MEDICAL CENTER INC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2300 E 30th St Ste B-102",
            "city": "Farmington",
            "state": "NM",
            "country_code": "US",
            "postal_code": "874018991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, NM

Sources for this page

Verify at the official NPI Registry.