Roswell Osteopathic Medical Clinic, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

ROSWELL OSTEOPATHIC MEDICAL CLINIC, INC

Practice address

111 W. Hobbs St.
Roswell, NM 88203

Phone

(575) 623-3311

Fax

(575) 622-1273

NPI assigned

Oct 3, 2006

Last updated

Jan 22, 2015By 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

Mr. Beau T Baumann

Title

Ceo/Administrator

Phone

(575) 623-3311

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

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

CLIA laboratory certificates

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Roswell Medical Care

  • Health Maintenance Organization
  • Roswell, NM
  • NPI 1710127220
  NPPES parent name

Practitioners 5

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.

• Mark Leroy Andrews, MD

  • Family Medicine Physician
  • Roswell, NM
  • NPI 1154420735
  Medicare reassignment Care Compare group NPD
• Bracie Been, PMHNP-BC

  • Family Nurse Practitioner
  • Roswell, NM
  • NPI 1396477493
  Medicare reassignment Care Compare group NPD
• Linda Y Jones, CNP

  • Nurse Practitioner
  • Roswell, NM
  • NPI 1255588067
  Medicare reassignment NPD
• Jennifer May, AGNP

  • Gerontology Nurse Practitioner
  • Roswell, NM
  • NPI 1285119651
  Medicare reassignment NPD
• Tonia Elizabeth Montoya, FNP-C

  • Family Nurse Practitioner
  • Roswell, NM
  • NPI 1023780293
  Medicare reassignment NPD

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421884800000",
    "number": "1144314287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W. HOBBS ST.",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88203",
            "telephone_number": "575-623-3311",
            "fax_number": "575-622-1273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W. HOBBS ST.",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88203",
            "telephone_number": "575-623-3311",
            "fax_number": "575-622-1273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSWELL OSTEOPATHIC MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-01-22",
        "status": "A",
        "authorized_official_last_name": "BAUMANN",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "575-623-3311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45567",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roswell Independent School District
• Roswell Infusions LLC
• Roswell Medical Care
• Roswell Operations, LLC
• Roswell Oral & Facial Surgery, LLC
• Roswell Skin Center, LLC
• Roswell Surgery Center LLC
• Brianne Rowell, FNP
• Jane Laurie Rowland, L.I.S.W.
• Ruben a. Supan, LLC

• Family Medicine Physician in Roswell, NM
• Providers in Roswell, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.