NPIMap

Organization Active NPI

San Miguel Clinic Corp

  • Rural Health Clinic/Center
  • Las Vegas, NM
National Provider Identifier
1306233846
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
SAN MIGUEL CLINIC CORP
Practice address
2515 Ridge Runner Rd
Las Vegas, NM 87701-4972
Phone
(505) 454-0322
Fax
(505) 425-6410
NPI assigned
Apr 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
James P Wright
Title
Sr. Director
Phone
(615) 465-7587

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

2515 Ridge Runner Rd
Las Vegas, NM 87701-4972

Mailing address

PO Box 689022
Franklin, TN 37068-9022
Phone (888) 422-1522

Other names 1

  • LV Medical Group- Family Medicine Doing business as

National Provider Directory

National Provider Directory
Tax ID family
LV Medical Group- Family Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1306233846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 689022",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370689022",
            "telephone_number": "888-422-1522",
            "fax_number": "615-628-6984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 RIDGE RUNNER RD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014972",
            "telephone_number": "505-454-0322",
            "fax_number": "505-425-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MIGUEL CLINIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SR. DIRECTOR",
        "authorized_official_telephone_number": "615-465-7587"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LV Medical Group- Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.