Pecos Valley of New Mexico, LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

PECOS VALLEY OF NEW MEXICO, LLC

Practice address

2420 W Pierce St
Suite 200 B
Carlsbad, NM 88220-3543

Phone

(505) 628-1589

NPI assigned

Apr 25, 2006

Organization subpart

No

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

Authorized official

Name

Debbie T Brewer

Title

Director

Phone

(877) 892-9813

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

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

• Pecos Valley of New Mexico, LLC

  • General Practice Physician
  • Carlsbad, NM
  • NPI 1194781021

  O20031216000086

  Same enrollment
• Pecos Valley of New Mexico, LLC

  • General Practice Physician
  • Carlsbad, NM
  • NPI 1831141258

  O20031216000086

  Same enrollment
• Pecos Valley of New Mexico, LLC

  • General Practice Physician
  • Carlsbad, NM
  • NPI 1972569820

  O20031216000086

  Same enrollment

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1326004755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2430 W PIERCE ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203553",
            "telephone_number": "505-628-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2420 W PIERCE ST",
            "address_2": "SUITE 200 B",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882203543",
            "telephone_number": "505-628-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECOS VALLEY OF NEW MEXICO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "877-892-9813"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61981273",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diaja Parker, BS, RDMS, RVT
• Jennifer Louise Parraz, LCSW
• Pecos Cyber Academy
• Pecos Valley of New Mexico LLC
• Pecos Valley of New Mexico, LLC
• Pecos Valley of New Mexico, LLC
• Pecos Valley of New Mexico, LLC
• Leonel Perez-Limonte, MD, MS-HQPS, MHL
• Caroline Marie Perkins, RN
• Lisa J Perkowski, MD P.C.

• General Practice Physician in Carlsbad, NM
• Providers in Carlsbad, NM by specialty
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.