NPIMap

Organization Active NPI

New Mexico Premier Health

  • Primary Care Nurse Practitioner
  • Los Lunas, NM
National Provider Identifier
1346071586
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
NEW MEXICO PREMIER HEALTH
Practice address
235 Main St SE
Los Lunas, NM 87031-7316
Phone
(505) 388-2223
NPI assigned
Aug 9, 2024
Last updated
Jun 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Amanda Christine RenfroNPI 1598320251
Title
CNP Cfo/Cmo
Phone
(817) 897-5310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU
Adult Health Nurse Practitioner 363LA2200X NU
Gerontology Nurse Practitioner 363LG0600X NU
Primary Care Nurse Practitioner 363LP2300X NU Primary

Addresses

Primary practice location

235 Main St SE
Los Lunas, NM 87031-7316

Mailing address

235 Main St SE
Los Lunas, NM 87031-7316
Phone (505) 388-2223

Other practice location 1

470 Sandsage Rd NW
Los Lunas, NM 87031
Phone (505) 604-7245

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240917004468 NM Part B Supplier - Clinic/Group Practice 4385185354 Receives reassigned benefits from 7 practitioners
Practice locations: Los Lunas, NM

National Provider Directory

National Provider Directory

Locations

235 Main St SE
Los Lunas, NM 87031
Phone (505) 388-2223

470 Sand Sage Rd NW
Los Lunas, NM 87031
Phone (505) 388-2223

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1346071586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 MAIN ST SE",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317316",
            "telephone_number": "505-388-2223",
            "fax_number": "505-404-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MAIN ST SE",
            "city": "LOS LUNAS",
            "state": "NM",
            "postal_code": "870317316",
            "telephone_number": "505-388-2223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "470 Sandsage Rd NW",
            "address_purpose": "LOCATION",
            "city": "Los Lunas",
            "state": "NM",
            "postal_code": "87031",
            "country_code": "US",
            "telephone_number": "505-604-7245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW MEXICO PREMIER HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-09",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-03",
        "status": "A",
        "authorized_official_last_name": "RENFRO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "CNP CFO/CMO",
        "authorized_official_telephone_number": "817-897-5310"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Lunas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.