NPIMap

Organization Active NPI

Southeast New Mexico Podiatry Associates Inc

Doing business as Southeast New Mexico Podiatry

  • Foot & Ankle Surgery Podiatrist
  • Carlsbad, NM
National Provider Identifier
1235226614
Registry record updated Nov 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SOUTHEAST NEW MEXICO PODIATRY ASSOCIATES INC
Doing business as
Southeast New Mexico Podiatry
Practice address
1016 W Pierce St
Carlsbad, NM 88220-4013
Phone
(575) 885-3445
Fax
(575) 887-0163
NPI assigned
Oct 6, 2006
Last updated
Nov 5, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2010

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

Authorized official

Name
Dr. Lyle Rey Folsom, DPMNPI 1770698334
Title
Owner Physician
Phone
(575) 885-3445

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X
Foot & Ankle Surgery Podiatrist 213ES0103X Primary

Addresses

Primary practice location

1016 W Pierce St
Carlsbad, NM 88220-4013

Mailing address

1016 W Pierce St
Carlsbad, NM 88220-4013
Phone (575) 885-3445

Other identifiers 2

IdentifierTypeStateIssuer
89008863MedicaidNM
DA5243OtherNMRR MEDICARE

Other names 1

  • Southeast New Mexico Podiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080505000548 NM Part B Supplier - Clinic/Group Practice 2668551425 Receives reassigned benefits from 3 practitioners
Practice locations: Carlsbad, NM; Hobbs, NM
O20100930034622 NM DME Supplier - Physician - Podiatry 2668551425 Practice locations: Carlsbad, NM

National Provider Directory

National Provider Directory

Locations

5419 N Lovington Hwy
Ste 9
Hobbs, NM 88240
Phone (505) 392-8718

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288915200000",
    "number": "1235226614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 W PIERCE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882204013",
            "telephone_number": "575-885-3445",
            "fax_number": "575-887-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 W PIERCE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882204013",
            "telephone_number": "575-885-3445",
            "fax_number": "575-887-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST NEW MEXICO PODIATRY ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-11-05",
        "status": "A",
        "authorized_official_last_name": "FOLSOM",
        "authorized_official_first_name": "LYLE",
        "authorized_official_middle_name": "REY",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "575-885-3445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89008863",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "DA5243",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southeast New Mexico Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Carlsbad, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.