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Presbyterian Medical Services

Organization Active NPI Federally Qualified Health Center (FQHC) · Santa Fe, NM

NPI 1114094547 · NPPES record last updated Jan 9, 2021

Key facts

NPI
1114094547
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
License
CL00007507 (NM)
Legal business name
PRESBYTERIAN MEDICAL SERVICES
Practice address
4851 Paseo del Sol
Santa Fe, NM 87507-3027
Phone
(505) 467-1081
Fax
(505) 954-1180
NPI assigned
Nov 29, 2006
Organization subpart
No

Authorized official

Name
Doug Smith
Title
Executive Vice President
Phone
(505) 982-5565

Corporate family (same tax ID) 20

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D1035517Presbyterian Medical Services Teen Health Centers
4851 Paseo del Sol, Santa Fe, NM 87507		Certificate of waiverAug 14, 2026

National Provider Directory

Tax ID family
PMS Questa Health Cente (70 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CL00007507 NM Yes

Addresses

Primary practice location

4851 Paseo del Sol
Santa Fe, NM 87507-3027

Mailing address

PO Box 2267
Santa Fe, NM 87504-2267
Phone (505) 982-5565

Other identifiers

IdentifierTypeStateIssuer
70935521MedicaidNM

Other names

  • Teen Health Centers Capital High Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 9, 2021.

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610150400000",
    "number": "1114094547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2267",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875042267",
            "telephone_number": "505-982-5565",
            "fax_number": "505-992-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4851 PASEO DEL SOL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875073027",
            "telephone_number": "505-467-1081",
            "fax_number": "505-954-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2021-01-09",
        "certification_date": "2021-01-09",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "505-982-5565"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NM",
            "license": "CL00007507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70935521",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Teen Health Centers Capital High",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Teen Health Centers Capital High",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

All providers in Santa Fe, NM · Federally Qualified Health Center (FQHC) in New Mexico

Sources for this page

Verify at the official NPI Registry.