Sunrise Medical Group, PC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

6794 Issued in NM

Legal business name

SUNRISE MEDICAL GROUP, PC

Practice address

552 Highway 54
Santa Rosa, NM 88435-2215

Phone

(505) 433-5572

Fax

(877) 651-1259

NPI assigned

Nov 6, 2006

Last updated

Oct 11, 2023By 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

Jessica Sanchez, DIRECTOR

Title

Credentialing

Phone

(575) 472-4311

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Locations

Practitioners 1

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.

• Nancy Louise Brannin, CNM

  • Advanced Practice Midwife
  • Las Vegas, NM
  • NPI 1518945708
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1124107446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 HIGHWAY 54",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352215",
            "telephone_number": "505-433-5572",
            "fax_number": "877-651-1259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 HIGHWAY 54",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352215",
            "telephone_number": "505-433-5572",
            "fax_number": "877-651-1259"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6739 Academy Rd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871093351",
            "country_code": "US",
            "telephone_number": "505-433-5572",
            "fax_number": "877-651-1259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUNRISE MEDICAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "575-472-4311",
        "authorized_official_credential": "DIRECTOR"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NM",
            "license": "6794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP ID",
            "identifier": "600521016",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00074686",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1124107446",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NM HEALTH DEPT. NO.",
            "identifier": "6794",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jessica.sanchez@srqc-med.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "552 Highway 54",
            "city": "Santa Rosa",
            "state": "NM",
            "country_code": "US",
            "postal_code": "884352215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Samantha Sullivan
• Sunrise Clinics (Sunrise Clinics - Santa Rosa High SBHC)
• Sunrise Clinics (Sunrise Clinics - Santa Rosa Elementary SBHC)
• Sunrise Clinics
• Sunrise Clinics (Sunrise Clinics - Santa Rosa Middle SBHC)
• Teambuilders Behavioral Health, LLC
• Estela Tenorio-Thompson
• Melissa Mae Thomas
• Janice Ulibarri
• Eddie Valdez, BMS

• Primary Care Clinic/Center in Santa Rosa, NM
• Providers in Santa Rosa, NM by specialty
• Primary Care Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.