Deming Hospital Corporation
Organization Active NPI Rural Health Clinic/Center · Deming, NM
NPI 1134526221 · NPPES record last updated Jul 7, 2023
Key facts
- NPI
- 1134526221
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- License
- 6552 (NM)
- Legal business name
- DEMING HOSPITAL CORPORATION
- Practice address
- 905 S 8TH St Ste B
Deming, NM 88030-4037 - Phone
- (575) 543-7200
- Fax
- (575) 543-7250
- NPI assigned
- Dec 4, 2014
- Organization subpart
- No
Authorized official
- Name
- Laura J Fey
- Title
- Sr. Director Physician Rev Cycle
- Phone
- (615) 221-3641
Other NPIs on the same Medicare enrollment 3
Other NPIs with the same Medicare PAC ID 2
Corporate family (same tax ID) 5
Related certifications (CCN) 1
Facilities with the same owner 32
Practitioners 50
-
David Neil Calkins, M.D.
-
Elizabeth A Donigan, CRNP
-
Thomas Allen McClendon, FNP-C
-
Jose Sanchez Sosa, APRN
-
Jaime Solis, M.D.
-
Sarah Patricia Summers-Barrio, DNP, FNP-BC
-
Khawaja N Anwar, MD
-
Hasan Adnan, M.D.
-
Victor Cruz, M.D.
-
Angela Edwards, D.P.M
-
Marina Fedotowsky, CFNP
-
George I Lafon, MD
-
Scott W McMahon, MD
-
Geronimo Mendoza Urias, M.D.
-
Michael Roland Murphy, D.O.
-
Jurido Olukunle, M.D.
-
Mark D Osmer, CNP
-
Michael Parrino, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NM
Rural health clinic certification: CCN 323408
- Legal name
- DEMING HOSPITAL CORPORATION
- Doing business as
- MIMBRES VALLEY MEDICAL GROUP
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- May 21, 2019
- Last certification
- May 7, 2025
- Ownership / control type
- 1B
- Organization structure
- Corporation · Proprietary
- Enrollment address
- 905 S 8TH St
Ste B
Deming, NM 88030-4037 - Related CCNs
- 321309
All disclosed owners & managing parties 12
| Name | Role | Since | Share |
|---|---|---|---|
| Henry Kunath |
Corporate Officer |
Sep 6, 2023 | |
| Corporate Director |
Sep 6, 2023 | ||
| Christopher M Harrison |
Corporate Officer |
Apr 1, 2025 | |
| Corporate Director |
Apr 1, 2025 | ||
| Trisha L Smith |
W-2 Managing Employee |
May 21, 2019 | |
| Quorum Health Corporation |
5% Or Greater Direct Ownership Interest | Apr 29, 2016 | 100% |
| Gtam Onshore Blocker 2 LLC |
5% Or Greater Indirect Ownership Interest | Dec 20, 2023 | 19.34% |
| Goldentree Distressed Onshore Master Fund III LP |
5% Or Greater Indirect Ownership Interest | Aug 5, 2020 | 6.8% |
| Laura Fey |
Corporate Director |
Aug 27, 2018 | |
| Goldentree Select Offshore Intermediate Fund LP |
5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 5.44% |
| Goldentree Distressed Master Fund III LTD |
5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 11% |
| Quincy Health LLC |
5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 100% |
| Steven W Frantz |
Corporate Officer |
Aug 10, 2022 | |
| Corporate Director |
Aug 10, 2022 | ||
| Donald Esposito |
Corporate Officer |
Sep 16, 2021 | |
| Corporate Director |
Sep 16, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040217000196 | NM | Part B Supplier - Clinic/Group Practice | 4981599206 |
Receives reassigned benefits from 39 practitioners 3 other NPIs on this enrollment Practice locations: Deming, NM |
| O20181205001053 | NM | Part a Provider - Rural Health Clinic | 4981599206 | Practice locations: Deming, NM |
National Provider Directory
- Tax ID family
- Mimbres Memorial Hospit
Locations
905 S 8th St
Ste B
Deming, NM 88030
Phone (575) 543-7200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | 6552 | NM | Yes |
Addresses
Primary practice location
905 S 8TH St Ste B
Deming, NM 88030-4037
Mailing address
PO Box 19072
Belfast, ME 04915-4085
Phone (575) 543-7200
Other names
- Mimbres Valley Medical Group
Other providers in Deming, NM
- Deming Dental and Oral Surgery Center
- Deming Dental Services, P.a.
- Deming Emergency Physicians
- Deming Home Care Services LLC
- Deming Hospital Corporation
- Deming Hospital Corporation
- Deming Hospital Corporation
- Deming Hospital Corporation
- Deming Hospital Corporation
- Deming Hospital Corporation
All providers in Deming, NM · Rural Health Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.