Clayton Health Systems Inc
Organization Active NPI Critical Access Hospital Clinic/Center · Clayton, NM
NPI 1285715243 · NPPES record last updated Sep 23, 2024
Key facts
- NPI
- 1285715243
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital Clinic/Center 261QC0050X
- License
- 3060 (NM)
- Legal business name
- CLAYTON HEALTH SYSTEMS INC
- Practice address
- 314 N 3Rd Ave
Clayton, NM 88415-3302 - Phone
- (505) 374-2273
- Fax
- (505) 374-0903
- NPI assigned
- Oct 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Tammie Chavez
- Title
- Ceo
- Phone
- (575) 347-2585
Owned or controlled facilities with NPI records 3
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 5
Practitioners 5
-
Jessie Jean Fluhman, FNP
-
Jessica Wright, CNP,DNP
-
Minh Chinh Nguyen, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
All facility ownership & control disclosures 4
| Facility | Type | Role | Since |
|---|---|---|---|
| Union County General Hospital |
Hospital | Operational/Managerial Control | Sep 1, 2008 |
| Union County General Hospital |
Hospital | Operational/Managerial Control (100%) | Sep 1, 2008 |
| Union County Health Center |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Oct 18, 2016 Oct 18, 2016 |
| Union County General Hospital |
Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Operational/Managerial Control (100%) |
Jan 1, 2020 Jan 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040219000112 | NM | Part B Supplier - Clinic/Group Practice | 0941195895 |
Receives reassigned benefits from 3 practitioners Practice locations: Clayton, NM |
National Provider Directory
- Tax ID family
- Clayton Health System
Locations
300 Wilson St
Clayton, NM 88415
Phone (575) 374-2585
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Critical Access Hospital Clinic/Center | 261QC0050X | 3060 | NM | Yes |
Addresses
Primary practice location
314 N 3Rd Ave
Clayton, NM 88415-3302
Mailing address
PO Box 489
Clayton, NM 88415-0489
Phone (505) 374-2585
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201040774 | Other | NM | PRESBYTERIAN CLINIC |
| NM009F48 | Other | NM | BC CLINIC |
| K5719 | Medicaid | NM |
Other providers in Clayton, NM
- Chelsey Elizabeth Cates
- Becky Jo Claycomb
- Clayton Health Facilities LP
- Clayton Health System
- Clayton Health Systems Inc
- Clayton Health Systems Inc
- Clayton Health Systems, Inc
- Clayton Health Systems, Inc
- Clayton Nursing and Rehab Center Opco, LLC
- Clayton Nursing Operations LLC
All providers in Clayton, NM · Critical Access Hospital Clinic/Center 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 Sep 23, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.