NPIMap

Organization Active NPI

Pearson Heart Clinic, LLC

  • Cardiovascular Disease Physician
  • Roswell, NM
National Provider Identifier
1104241173
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
2003-0352 Issued in NM
Legal business name
PEARSON HEART CLINIC, LLC
Practice address
313 W Country Club Rd
Roswell, NM 88201-5804
Phone
(575) 625-8430
NPI assigned
Feb 26, 2014
Last updated
Jun 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Authorized official

Name
Clarence E Pearson, MD
Title
Owner
Phone
(575) 625-8452

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 2003-0352 NM Primary

Addresses

Primary practice location

313 W Country Club Rd
Roswell, NM 88201-5804

Mailing address

1621 N Washington Ave
Roswell, NM 88201-3272
Phone (575) 625-8430

National Provider Directory

National Provider Directory

Locations

1621 N Washington Ave
Roswell, NM 88201
Phone (505) 625-8430

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1393372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1104241173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1621 N WASHINGTON AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882013272",
            "telephone_number": "575-625-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 W COUNTRY CLUB RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015804",
            "telephone_number": "575-625-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARSON HEART CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-26",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "PEARSON, MD",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-625-8452"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NM",
            "license": "2003-0352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.