South Central Colfax County Hospital District

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SOUTH CENTRAL COLFAX COUNTY HOSPITAL DISTRICT

Practice address

31039B Hwy 64
Cimarron, NM 87714-9646

Phone

(575) 377-3301

Fax

(575) 376-2107

NPI assigned

Jun 1, 2009

Organization subpart

Yes

Parent organization

SOUTH CENTRAL COLFAX COUNTY HOSPITAL DISTRICTAs reported in NPPES

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

Authorized official

Name

Annabelle Sillas-Graves

Title

Administrator

Phone

(575) 377-3301

Specialties & licenses 1

Addresses

Other names 1

• CIMARRON HEALTHCARE CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• South Central Colfax County Special Hospital District

  • Health Service Clinic/Center
  • Angel Fire, NM
  • NPI 1215163639

  O20111019000475

  Same enrollment

Part of

South Central Colfax County Special Hospital District

Locations

Practitioners 4

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

• Valerie A Burgelin, CFNP

  • Nurse Practitioner
  • Las Cruces, NM
  • NPI 1649290081
  NPD
• Margaret Vanantwerp, CNP

  • Family Nurse Practitioner
  • Angel Fire, NM
  • NPI 1619177599
  NPD
• Michael J Rossi, M.D.

  • Family Medicine Physician
  • Fort Stewart, GA
  • NPI 1679630388
  NPD
• Kyle Deisig, FNP-C

  • Nurse Practitioner
  • Angel Fire, NM
  • NPI 1578388633
  NPD (past)

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1124254545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31039B HWY 64",
            "city": "CIMARRON",
            "state": "NM",
            "postal_code": "877149646",
            "telephone_number": "575-377-3301",
            "fax_number": "575-376-2107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31039B HWY 64",
            "city": "CIMARRON",
            "state": "NM",
            "postal_code": "877149646",
            "telephone_number": "575-377-3301",
            "fax_number": "575-376-2107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL COLFAX COUNTY HOSPITAL DISTRICT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL COLFAX COUNTY HOSPITAL DISTRICT",
        "enumeration_date": "2009-06-01",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "SILLAS-GRAVES",
        "authorized_official_first_name": "ANNABELLE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "575-377-3301"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CIMARRON HEALTHCARE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alison Gagnon, FNP-C
• Henry K Hillman, MD
• Abbie L Laursen, MD
• Presbyterian Healthcare Services
• Melissa Smith, LPN
• Sunrise Clinics
• Kathleen Anne Veit, MS LPCC
• Village of Cimarron
• Elizabeth A Wallace
• Lisa A Wentling, PA-C

• All providers in Cimarron, NM
• Health Service Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.