NPIMap

Organization Active NPI

Regents of New Mexico State University

  • Audiologist
  • Las Cruces, NM
National Provider Identifier
1275909871
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
6545 Issued in NM
Legal business name
REGENTS OF NEW MEXICO STATE UNIVERSITY
Practice address
3600 Arrowhead Dr
BLDG 08
Las Cruces, NM 88011
Phone
(575) 674-0593
NPI assigned
Aug 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Dr. Marlene Salas-Provance, PHD CCC-SLP
Title
Executive Director
Phone
(575) 646-2402

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X 6545 NM Primary

Addresses

Primary practice location

3600 Arrowhead Dr
BLDG 08
Las Cruces, NM 88011

Mailing address

3600 Arrowhead Rd
Building 08
Las Cruces, NM 88011-5129
Phone (575) 674-0593

Other identifiers 1

IdentifierTypeStateIssuer
90123280MedicaidNM

Other names 1

  • NMSU Hearing Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
New Mexico State University Student Health Center7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

3600 Arrowhead Rd
Bldg 8
Las Cruces, NM 88011
Phone (575) 674-0593

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1275909871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ARROWHEAD RD",
            "address_2": "BUILDING 08",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115129",
            "telephone_number": "575-674-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 ARROWHEAD DR",
            "address_2": "BLDG 08",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "575-674-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF NEW MEXICO STATE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "SALAS-PROVANCE",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "575-646-2402",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "NM",
            "license": "6545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90123280",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NMSU Hearing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.