NPIMap

Organization Active NPI

Presbyterian Healthcare Services

Doing business as Dr dan C Trigg Swing Bed

  • Critical Access Hospital
  • Tucumcari, NM
National Provider Identifier
1235115676
Registry record updated Aug 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
3011 Issued in NM
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
Dr dan C Trigg Swing Bed
Practice address
301 E Miel de Luna Ave
Tucumcari, NM 88401-3810
Phone
(505) 461-0141
Fax
(505) 461-1822
NPI assigned
Dec 19, 2005
Last updated
Aug 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2010

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

Authorized official

Name
Mr. Robert Garcia
Title
VP Regional Operations
Phone
(505) 923-5339

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Critical Access Hospital 282NC0060X 3011 NM Primary

Addresses

Primary practice location

301 E Miel de Luna Ave
Tucumcari, NM 88401-3810

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other names 1

  • Dr dan C Trigg Swing Bed Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090305000600 NM Part A Provider - Critical Access Hospital 9234041708 Receives reassigned benefits from 1 practitioner
Practice locations: Tucumcari, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1235115676. Details of each certification follow.

Hospital certification: CCN 32Z302

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
DR. DAN C. TRIGG MEMORIAL HOSPITAL
Organization structure
OtherNon-profit
Incorporated
in NM
Enrollment address
301 E Miel de Luna
Dr. Dan C. Trigg Memorial Hospital
Tucumcari, NM 88401-3810
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

National Provider Directory

National Provider Directory
Tax ID family
Cimarron Healthcare Clinic69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly Poland Individual W-2 Managing EmployeeManager Provider Enrollment Jan 1, 2011
Dale Maxwell Individual W-2 Managing EmployeePresident Ceo Jan 1, 2011
Operational/Managerial ControlPresident Ceo Jan 1, 2011
Steven Figge Individual Corporate DirectorDirector of Mso Jan 1, 2010
W-2 Managing EmployeeDirector of Mso Jan 1, 2010
Presbyterian Healthcare Services Organization, Tucumcari, NM Non-profit Operational/Managerial Control Mar 15, 2000

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Presbyterian Espanola HospitalEspanola, NM, CCN 320011 Hospital Operational/Managerial Control May 24, 1948
Plains Regional Medical Center ClovisClovis, NM, CCN 320022 Hospital Operational/Managerial Control Jan 1, 1978
Socorro General HospitalSocorro, NM, CCN 32Z301 Hospital Operational/Managerial Control Mar 30, 2000
Socorro General HospitalSocorro, NM, CCN 321301 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 321302 Hospital Operational/Managerial Control Mar 30, 2000
Socorro General Hospital Home HealthcareSocorro, NM, CCN 327027 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 1, 2000
Jan 19, 2009
Plains Regional Medical Center Clovis Home HealthcareClovis, NM, CCN 327305 Home health agency 5% Or Greater Direct Ownership Interest Feb 14, 1979
Tucumcari HospiceTucumcari, NM, CCN 321566 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 1, 2009
Dec 1, 2009

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 2

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.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281312000000",
    "number": "1235115676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E MIEL DE LUNA AVE",
            "city": "TUCUMCARI",
            "state": "NM",
            "postal_code": "884013810",
            "telephone_number": "505-461-0141",
            "fax_number": "505-461-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-19",
        "last_updated": "2010-08-09",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "VP REGIONAL OPERATIONS",
        "authorized_official_telephone_number": "505-923-5339",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NM",
            "license": "3011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr dan C Trigg Swing Bed",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucumcari, NM

Sources for this page

Verify at the official NPI Registry.