NPIMap

Organization Active NPI

Peak Medical Assisted Living, LLC

  • Skilled Nursing Facility
  • Las Cruces, NM
National Provider Identifier
1194772939
Registry record updated Nov 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5841 Issued in NM
Legal business name
PEAK MEDICAL ASSISTED LIVING, LLC
Practice address
2884 N Roadrunner Pkwy
Las Cruces, NM 88011-0853
Phone
(575) 522-1110
NPI assigned
May 27, 2006
Organization subpart
Yes
Parent organization
PEAK MEDICAL, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2018

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

Authorized official

Name
Michael Berg
Title
Assistant Secretary
Phone
(505) 468-4752

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 5788 NM
Alzheimer Center (Dementia Center) 311500000X 5789 NM
Skilled Nursing Facility 314000000X 5841 NM Primary

Addresses

Primary practice location

2884 N Roadrunner Pkwy
Las Cruces, NM 88011-0853

Mailing address

2884 N Roadrunner Pkwy
Las Cruces, NM 88011-0853
Phone (575) 522-1110

Other identifiers 2

IdentifierTypeStateIssuer
PROVA41670OtherNMMOLINA
M156OtherNMBC/BS OF NM

Other names 1

  • The Village at Northrise-Desert Willow I Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543276800000",
    "number": "1194772939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2884 N ROADRUNNER PKWY",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880110853",
            "telephone_number": "575-522-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2884 N ROADRUNNER PKWY",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880110853",
            "telephone_number": "575-522-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK MEDICAL ASSISTED LIVING, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEAK MEDICAL, LLC",
        "enumeration_date": "2006-05-27",
        "last_updated": "2018-11-27",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NM",
            "license": "5788",
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NM",
            "license": "5789",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NM",
            "license": "5841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOLINA",
            "identifier": "PROVA41670",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF NM",
            "identifier": "M156",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Village at Northrise-Desert Willow I",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Village at Northrise-Desert Willow I",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.