NPIMap

Organization Active NPI

Lovelace Health System, Inc.

  • Cardiovascular Disease Physician
  • Roswell, NM
National Provider Identifier
1306238183
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
LOVELACE HEALTH SYSTEM, INC.
Practice address
311 W Country Club Rd
Suite 1
Roswell, NM 88201-5839
Phone
(575) 623-2836
Fax
(575) 623-2841
NPI assigned
Mar 3, 2015
Organization subpart
Yes
Parent organization
ARDENT LEGACY HOLDINGS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Authorized official

Name
Stephen C Petrovich
Title
SVP
Phone
(615) 296-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

311 W Country Club Rd
Suite 1
Roswell, NM 88201-5839

Mailing address

1 Burton Hills Blvd
Suite 250
Nashville, TN 37215-6293
Phone (615) 296-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031210000397 NM Part B Supplier - Clinic/Group Practice 9739099326 Receives reassigned benefits from 65 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Roswell, NM; Albuquerque, NM

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1425340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1306238183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BURTON HILLS BLVD",
            "address_2": "SUITE 250",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156293",
            "telephone_number": "615-296-3000",
            "fax_number": "615-296-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 W COUNTRY CLUB RD",
            "address_2": "SUITE 1",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015839",
            "telephone_number": "575-623-2836",
            "fax_number": "575-623-2841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVELACE HEALTH SYSTEM, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARDENT LEGACY HOLDINGS, LLC",
        "enumeration_date": "2015-03-03",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SVP",
        "authorized_official_telephone_number": "615-296-3000"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.