NPIMap

Organization Active NPI

Presbyterian Healthcare Services

Doing business as Plains Regional Medical Center Home Healthcare

  • Home Health Agency
  • Clovis, NM
National Provider Identifier
1295710176
Registry record updated Mar 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
6080 Issued in NM
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
Plains Regional Medical Center Home Healthcare
Practice address
2217 Dillon
Clovis, NM 88101-9454
Phone
(505) 923-5356
Fax
(505) 923-5354
NPI assigned
Dec 13, 2005
Last updated
Mar 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2014

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

Authorized official

Name
Mr. Bo Beames
Title
VP Regional Operations
Phone
(505) 923-5339

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Internal Medicine Physician 207R00000X
Home Health Agency 251E00000X 6080 NM Primary

Addresses

Primary practice location

2217 Dillon
Clovis, NM 88101-9454

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 1

IdentifierTypeStateIssuer
N4494MedicaidNM

Other names 1

  • Plains Regional Medical Center Home Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100929000170 NM Part A Provider - Home Health Agency 9234041708 Practice locations: Clovis, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1295710176. Details of each certification follow.

Home health agency certification: CCN 327305

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
PLAINS REGIONAL MEDICAL CENTER CLOVIS HOME HEALTHCARE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 14, 1979
Last certification
Feb 25, 2021
Ownership / control type
Non-Profit
Organization structure
OtherNon-profit
Enrollment address
2217 Dillon
Plains Regional Medical Center Home Healthcare
Clovis, NM 88101-9454

Care Compare: Home health agency

Medicare Care Compare
Listed as
Plains Regional Medical Center Home Health CareCCN 327305 · All quality measures
Overall star rating
2.5 of 5
Ownership
Non-Profit
Certified
Feb 14, 1979
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Colfax Laboratory69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

626 Brunken Ave
Salinas, CA 93901
Phone (831) 755-0600

Ownership & related parties

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly Poland Individual Corporate DirectorManager Provider Enrollment Jan 1, 2011
W-2 Managing EmployeeManager Provider Enrollment Jan 1, 2011
Steven Figge Individual Corporate DirectorDirector Mso Jan 1, 2010
W-2 Managing EmployeeDirector Mso Jan 1, 2010
Presbyterian Healthcare Services Organization, Albuquerque, NM Non-profit 5% Or Greater Direct Ownership Interest Feb 14, 1979

All facility ownership & control disclosures 8

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Presbyterian Espanola HospitalEspanola, NM, CCN 320011 Hospital Operational/Managerial Control May 24, 1948
Plains Regional Medical Center ClovisClovis, NM, CCN 320022 Hospital Operational/Managerial Control Jan 1, 1978
Socorro General HospitalSocorro, NM, CCN 32Z301 Hospital Operational/Managerial Control Mar 30, 2000
Socorro General HospitalSocorro, NM, CCN 321301 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 321302 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 32Z302 Hospital Operational/Managerial Control Mar 15, 2000
Socorro General Hospital Home HealthcareSocorro, NM, CCN 327027 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 1, 2000
Jan 19, 2009
Tucumcari HospiceTucumcari, NM, CCN 321566 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 1, 2009
Dec 1, 2009

Facilities with the same owner 8

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 8

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.

Affiliated clinicians 17

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394496000000",
    "number": "1295710176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 DILLON",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019454",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2014-03-11",
        "status": "A",
        "authorized_official_last_name": "BEAMES",
        "authorized_official_first_name": "BO",
        "authorized_official_title_or_position": "VP REGIONAL OPERATIONS",
        "authorized_official_telephone_number": "505-923-5339",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NM",
            "license": "6080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N4494",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plains Regional Medical Center Home Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, NM

Sources for this page

Verify at the official NPI Registry.