Eastern Plains Medical Group, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

89-82 Issued in NM

Legal business name

EASTERN PLAINS MEDICAL GROUP, P.C.

Practice address

350 W Country Club Rd
Suite 205
Roswell, NM 88201-5205

Phone

(505) 622-7593

Fax

(505) 622-5538

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Thomas C Nicholson, M.D.NPI 1366428096

Title

President

Phone

(505) 622-7593

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas C. Nicholson, M.D.

  • Urology Physician
  • Lubbock, TX
  • NPI 1366428096
  NPD (past) Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295828218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 W COUNTRY CLUB RD",
            "address_2": "SUITE 205",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015205",
            "telephone_number": "505-622-7593",
            "fax_number": "505-622-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 W COUNTRY CLUB RD",
            "address_2": "SUITE 205",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015205",
            "telephone_number": "505-622-7593",
            "fax_number": "505-622-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PLAINS MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "505-622-7593",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "89-82",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "P5116",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dynamic Rehab Solutions, LLC
• Terri D Eachus, OD
• Sarah Lynn East-Brumana, PA-C
• Eastern New Mexico University-Roswell Branch Community College
• Eastern New Mexico University-Roswell Branch Community College
• Maeve Ebright, CERTIFIED DOULA
• James Edwards
• Jessica Edwards
• Osarobo Ehigiator
• Ahmad El Alayli, M.D.

• All providers in Roswell, NM
• Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.