NPIMap

Organization Active NPI

DHHS,PHS,Naihs,Gallup Indian Medical Center

Doing business as Red Rock Care Center

  • Skilled Nursing Facility
  • Gallup, NM
National Provider Identifier
1245409960
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
9435
Legal business name
DHHS,PHS,NAIHS,GALLUP INDIAN MEDICAL CENTER
Doing business as
Red Rock Care Center
Practice address
3720 Church Rock St
Gallup, NM 87301-4572
Phone
(505) 722-1000
Fax
(505) 722-1310
NPI assigned
Feb 27, 2008
Last updated
Feb 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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

Authorized official

Name
Pamela Detsoi-Smiley, CEO
Title
Chief Executive Officer
Phone
(505) 722-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 9435 Primary

Addresses

Primary practice location

3720 Church Rock St
Gallup, NM 87301-4572

Mailing address

PO Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000

Other names 1

  • Red Rock Care Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000840 TX Part B Supplier - Clinic/Group Practice 3173436409 Receives reassigned benefits from 617 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gallup, NM; Tohatchi, NM

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Dhhsphsnaihsgallup Indian Medical Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Practitioners & affiliated clinicians

Practitioners 8

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": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1245409960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 CHURCH ROCK ST",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014572",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHHS,PHS,NAIHS,GALLUP INDIAN MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "DETSOI-SMILEY",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "505-722-1000",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": "9435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Rock Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.