Active NPI
PHC-Los Alamos Inc
Doing business as Los Alamos Medical Center
- Rural Acute Care Hospital
- Los Alamos, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rural Acute Care Hospital
- License
- 3086
- Legal business name
- PHC-LOS ALAMOS INC
- Doing business as
- Los Alamos Medical Center
- Practice address
- 3917 West Rd
Los Alamos, NM 87544-2275 - Phone
- (505) 662-4201
- Fax
- (505) 661-9598
- NPI assigned
- Nov 29, 2006
- Last updated
- Apr 30, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Charlotte Lawrence
- Title
- Secretary
- Phone
- (615) 920-7000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Acute Care Hospital | 282NR1301X | 3086 | NM | Primary |
Addresses
Primary practice location
3917 West Rd
Los Alamos, NM 87544-2275
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000
Other names 1
- Los Alamos Medical Center
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | losalamos@yourcarecommunity.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030103000007 | TX | Part A Provider - Hospital | 6901713502 | Practice locations: Espanola, NM; Los Alamos, NM |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1285701623. Details of each certification follow.
Hospital certification: CCN 320033
- Legal name
- PHC-LOS ALAMOS INC.
- Doing business as
- LOS ALAMOS MEDICAL CENTER
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Jul 1, 1966
- Last certification
- Aug 16, 2024
- Beds
- 53
- Ownership / control type
- Private (for profit)
- Most recent change of ownership
- Jun 1, 2002 (1 total)
- Organization structure
- Corporation
- Incorporated
- Feb 19, 2002 in NM
- Enrollment address
- 3917 West Road
Los Alamos Medical Center
Los Alamos, NM 87544-2275 - Hospital subgroups
- Acute care, Short-term
Care Compare: Hospital
Medicare Care Compare- Listed as
- Los Alamos Medical Center
- Type
- Acute Care Hospitals
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 32D0536733 | PHC Los Alamos Inc Dba Los Alamos | Accreditation | Jun 13, 2027 |
| 32D0931276 | PHC Los Alamos Inc Dba Los Alamos | Certificate of waiver | Jul 24, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- PHC Los Alamos Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Los Alamos Medical Center Outpatient Pharmacy
- Clinic Pharmacy
- Los Alamos, NM
- NPI 1821130626
-
- Emergency Medical Services (Emergency Medicine) Physician
- Los Alamos, NM
- NPI 1023147097
Member organizations 1
Organizations listed as members of this organization in the National Provider Directory.
-
dba Los Alamos Medical Center - swing bed unit
- Medicare Defined Swing Bed Hospital Unit
- Los Alamos, NM
- NPI 1215005129
Member Of
Interoperability endpoints
- losalamos@yourcarecommunity.org
Ownership & related parties
All disclosed owners & managing parties 12
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lifepoint Corporate Services General Partnership | Operational/Managerial Control | Apr 15, 2005 | |
| Tracie Stratton | Operational/Managerial Control | Jul 20, 2022 | |
| DSB Acquisition LLC | 5% Or Greater Indirect Ownership Interest | Nov 16, 2018 | 100% |
| Province Healthcare Company LLC | 5% Or Greater Direct Ownership Interest | Apr 15, 2005 | 100% |
| Lifepoint Health Inc | 5% Or Greater Indirect Ownership Interest | Nov 16, 2018 | 100% |
| Marcus B Poppell | Corporate Officer | Nov 2, 2009 | |
| William Ziesmer | Corporate Officer | Feb 12, 2024 | |
| Corporate Director | Feb 12, 2024 | ||
| Charlotte E Lawrence | Corporate Officer | Apr 4, 2022 | |
| Samuel Robert Barrett | Corporate Officer | Feb 2, 2026 | |
| Elliott Brown | Corporate Officer | Apr 2, 2026 | |
| Christopher J Monte | Corporate Officer | Jun 27, 2005 | |
| Legacy Lifepoint Health LLC | 5% Or Greater Indirect Ownership Interest | Apr 15, 2005 | 100% |
Facilities with the same owner 195
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Memorial Medical Center of Las Cruces
- General Acute Care Hospital
- Las Cruces, NM
- NPI 1700821808
Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership, Province Healthcare Company LLC
-
dba UP Health System Bell
- Critical Access Hospital
- Ishpeming, MI
- NPI 1699101345
Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership
-
dba UP Health System Bell
- Medicare Defined Swing Bed Hospital Unit
- Ishpeming, MI
- NPI 1760819858
Legacy Lifepoint Health LLC, Lifepoint Corporate Services General Partnership
-
dba Summertown Medical Center
- Rural Health Clinic/Center
- Mt Pleasant, TN
- NPI 1255069639
Legacy Lifepoint Health LLC
-
dba First Choice Health Lawrenceburg
- Rural Health Clinic/Center
- Lawrenceburg, TN
- NPI 1023840998
Legacy Lifepoint Health LLC
-
dba Southern Tennessee Internal Medicine - Lawrenceburg
- Rural Health Clinic/Center
- Lawrenceburg, TN
- NPI 1417739640
Legacy Lifepoint Health LLC
-
dba First Choice Health Loretto
- Rural Health Clinic/Center
- Loretto, TN
- NPI 1811543929
Legacy Lifepoint Health LLC
-
dba Women's Health Clinic
- Rural Health Clinic/Center
- Lawrenceburg, TN
- NPI 1891580858
Legacy Lifepoint Health LLC
-
dba Southern Tennessee Family Health - Pulaski
- Rural Health Clinic/Center
- Pulaski, TN
- NPI 1063294296
Legacy Lifepoint Health LLC
-
dba Southern Tennessee Primary Care Eastside
- Rural Health Clinic/Center
- Pulaski, TN
- NPI 1144052002
Legacy Lifepoint Health LLC
-
dba Southern Tennessee Primary Care Lynnville
- Rural Health Clinic/Center
- Lynnville, TN
- NPI 1407688369
Legacy Lifepoint Health LLC
-
dba Southern Tennessee Primary Care Ardmore
- Rural Health Clinic/Center
- Ardmore, TN
- NPI 1558117028
Legacy Lifepoint Health LLC
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Internal Medicine Physician
- Flora, IL
- NPI 1437445947
Affiliated clinicians 175
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714435200000",
"number": "1285701623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 SEVEN SPRINGS WAY",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370275098",
"telephone_number": "615-920-7000",
"fax_number": "615-920-8913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3917 WEST RD",
"city": "LOS ALAMOS",
"state": "NM",
"postal_code": "875442275",
"telephone_number": "505-662-4201",
"fax_number": "505-661-9598"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PHC-LOS ALAMOS INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-29",
"last_updated": "2024-04-30",
"certification_date": "2024-04-30",
"status": "A",
"authorized_official_last_name": "LAWRENCE",
"authorized_official_first_name": "CHARLOTTE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "615-920-7000"
},
"taxonomies": [
{
"code": "282NR1301X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital, Rural",
"state": "NM",
"license": "3086",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "losalamos@yourcarecommunity.org",
"affiliation": "N",
"address_1": "3917 West Rd",
"city": "Los Alamos",
"state": "NM",
"country_code": "US",
"postal_code": "875442275",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "Los Alamos Medical Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Los Alamos Medical Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Los Alamos, NM
- Elisabeth Scherf Perry, PH.D.
- Melissa Jane Petty, NP
- PHC- Los Alamos Inc (Los Alamos Medical Center Outpatient Pharmacy)
- PHC-Los Alamos Inc
- PHC-Los Alamos Inc (Los Alamos Medical Center - swing bed unit)
- Physical Therapy Plus Inc
- Petra Pirc, MSPT
- Tina Lynn Platte
- Sara Pocernik, R.D.
- Enrique Posada, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.