NPIMap

Organization Active NPI

San Juan Regional Medical Center Inc

Doing business as Sjrmc Internal Medicine

  • Internal Medicine Physician
  • Farmington, NM
National Provider Identifier
1225076003
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SAN JUAN REGIONAL MEDICAL CENTER INC
Doing business as
Sjrmc Internal Medicine
Practice address
407 S. Schwartz Ave
Suite 201
Farmington, NM 87401-5973
Phone
(505) 609-6730
Fax
(505) 609-6749
NPI assigned
Jun 3, 2006
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SAN JUAN REGIONAL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Kim Byrd
Title
Administrative Director of Reimburs
Phone
(505) 609-2258

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU
Pulmonary Disease Physician 207RP1001X NU

Addresses

Primary practice location

407 S. Schwartz Ave
Suite 201
Farmington, NM 87401-5973

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other identifiers 1

IdentifierTypeStateIssuer
000Q6471MedicaidNM

Other names 1

  • SJRMC INTERNAL MEDICINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000865 NM Part B Supplier - Clinic/Group Practice 4587559505 Receives reassigned benefits from 396 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Farmington, NM; Bloomfield, NM; Aztec, NM

Other NPIs on the same Medicare enrollment 18

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

View all 18

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D0943695Sjrmc Internal Medicine407 South Schwartz Suite 201, Farmington, NM 87401Provider-performed microscopyAug 23, 2027

National Provider Directory

National Provider Directory
Tax ID family
San Juan Hospital13 organizations share this tax ID, including this one
Part of
San Juan Hospital

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

120 Llano St
Aztec, NM 87410
Phone (505) 334-3404

2700 Farmington Ave
Bldg F2
Farmington, NM 87401
Phone (505) 327-6688

312 S Lake St
Farmington, NM 87401

407 S Schwartz Ave
Ste 201
Farmington, NM 87401
Phone (505) 609-6300

4251 English Rd
Farmington, NM 87402
Phone (505) 609-6610

4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610

10 Road 6400
Kirtland, NM 87417
Phone (505) 598-0566

Practitioners & affiliated clinicians

Practitioners 48

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.

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1225076003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 S. SCHWARTZ AVE",
            "address_2": "SUITE 201",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015973",
            "telephone_number": "505-609-6730",
            "fax_number": "505-609-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN JUAN REGIONAL MEDICAL CENTER INC",
        "enumeration_date": "2006-06-03",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "BYRD",
        "authorized_official_first_name": "KIM",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR OF REIMBURS",
        "authorized_official_telephone_number": "505-609-2258"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000Q6471",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJRMC INTERNAL MEDICINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.