PHC-Los Alamos Inc
Organization Active NPI Rural Acute Care Hospital · Los Alamos, NM
NPI 1285701623 · NPPES record last updated Apr 30, 2024
Key facts
- NPI
- 1285701623
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Acute Care Hospital 282NR1301X
- License
- 3086 (NM)
- Legal business name
- PHC-LOS ALAMOS INC
- Practice address
- 3917 West Rd
Los Alamos, NM 87544-2275 - Phone
- (505) 662-4201
- Fax
- (505) 661-9598
- NPI assigned
- Nov 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Charlotte Lawrence
- Title
- Secretary
- Phone
- (615) 920-7000
Corporate family (same tax ID) 2
Member organizations 1
Facilities with the same owner 195
Practitioners 1
-
Gaurav Nigam, MD
Affiliated clinicians 175
-
Robert Amjad Ali, MD
-
Eric William Anderson, M.D.
-
Sarah Elizabeth Aragon, ACNP
-
Galina Batygina, P.A.
-
Richard Berry, CRNA
-
Luke William Bulthuis, M.D.
-
Pamela Anne Burks, PA-C
-
Bradford Lee Cambron, M.D.
-
Michelle W Carr, MD
-
Jodi Casados, MD
-
Lucas Chacon-Lutrick, M.D.
-
Andrea Lynn Chavez, CNP
-
Charnes Sy Chiu, MD
-
Ryan Commiskey, NP-C
Medicare Care Compare: Hospital
- Listed as
- Los Alamos Medical Center
- Type
- Acute Care Hospitals
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- Yes
Laboratory certificates & supplier records
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 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
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 · Proprietary
- 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
All disclosed owners & managing parties 12
| 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% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030103000007 | TX | Part a Provider - Hospital | 6901713502 | Practice locations: Espanola, NM; Los Alamos, NM |
National Provider Directory
- Tax ID family
- PHC-Los Alamos Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Acute Care Hospital | 282NR1301X | 3086 | NM | Yes |
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
- Los Alamos Medical Center
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | losalamos@yourcarecommunity.org |
Other providers in Los Alamos, NM
- Elisabeth Scherf Perry
- Melissa Jane Petty
- PHC- Los Alamos Inc
- PHC-Los Alamos Inc
- PHC-Los Alamos Inc
- Physical Therapy Plus Inc
- Petra Pirc
- Tina Lynn Platte
- Sara Pocernik
- Enrique Posada
All providers in Los Alamos, NM · Rural Acute Care Hospital in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.