Organization Active NPI

Hgu Enterprises, LLC

  • Pediatric Neurodevelopmental Disabilities Physician
  • Rio Rancho, NM
National Provider Identifier
1235996232
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Neurodevelopmental Disabilities PhysicianTaxonomy code 2080P0008X
Legal business name
HGU ENTERPRISES, LLC
Practice address
1101 Golf Course Rd SE Ste 103
Rio Rancho, NM 87124-4732
Phone
(505) 410-9548
NPI assigned
Mar 5, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Authorized official

Name
Mrs. Courtney Anne Lewis, MA LPCCNPI 1467472191
Title
Ceo
Phone
(505) 410-9548

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Neurodevelopmental Disabilities PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0008X Primary
Respite Care 385H00000X
Respite Care Camp 385HR2050X
Child Mental Illness Respite Care 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X
Child Physical Disabilities Respite Care 385HR2065X

Addresses

Primary practice location

1101 Golf Course Rd SE Ste 103
Rio Rancho, NM 87124-4732

Mailing address

1101 Golf Course Rd SE Ste 103
Rio Rancho, NM 87124-4732
Phone (505) 410-9548

Other identifiers 2

IdentifierTypeStateIssuer
1407350648MedicaidNM
1467472191MedicaidNM

Other names 1

  • We Rock the Spectrum Kid's Gym, Westside ABQ Doing business as

National Provider Directory

National Provider Directory

Locations

1101 Golf Course Rd SE
Ste 103
Rio Rancho, NM 87124
Phone (505) 410-9548

Practitioners & affiliated clinicians

Practitioners 1

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": "1709596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709596800000",
    "number": "1235996232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 GOLF COURSE RD SE STE 103",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244732",
            "telephone_number": "505-410-9548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 GOLF COURSE RD SE STE 103",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244732",
            "telephone_number": "505-410-9548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HGU ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-05",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-410-9548",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA LPCC"
    },
    "taxonomies": [
        {
            "code": "2080P0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407350648",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467472191",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "We Rock the Spectrum Kid's Gym, Westside ABQ",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.