Individual provider Active NPI

Clifford Thomas Kinnear Jr.

  • Health Educator
  • Alamogordo, NM
National Provider Identifier
1265079420
Registry record updated Dec 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Practice address
1003 McKinley Ave
Alamogordo, NM 88310-4246
Phone
(575) 921-1873
NPI assigned
Dec 6, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Educator 174H00000X Primary

Addresses

Primary practice location

1003 McKinley Ave
Alamogordo, NM 88310-4246

Mailing address

PO Box 30003
Las Cruces, NM 88003-8003
Phone (575) 646-5426

Other practice location 1

940 College Dr
Las Cruces, NM 88003-8003
Phone (575) 646-5426

Other practice location 2

1205 Lovers Ln
Alamogordo, NM 88310-5658
Phone (575) 921-1873

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico State University Health Educator CurrentSince Apr 5, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575590400000",
    "number": "1265079420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30003",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880038003",
            "telephone_number": "575-646-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 MCKINLEY AVE",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883104246",
            "telephone_number": "575-921-1873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "940 College Dr",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880038003",
            "country_code": "US",
            "telephone_number": "575-646-5426",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1205 Lovers Ln",
            "address_purpose": "LOCATION",
            "city": "Alamogordo",
            "state": "NM",
            "postal_code": "883105658",
            "country_code": "US",
            "telephone_number": "575-921-1873",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KINNEAR",
        "first_name": "CLIFFORD",
        "middle_name": "THOMAS",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-06",
        "last_updated": "2019-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamogordo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2019; 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.