Gutierrez Medical Group PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

GUTIERREZ MEDICAL GROUP PA

Practice address

1010 E Roosevelt Ave
Grants, NM 87020-2118

Phone

(505) 287-2948

Fax

(505) 287-5372

NPI assigned

Feb 8, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Maria Romero, RHIT

Title

Office Manager

Phone

(505) 287-2948

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356314504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 E ROOSEVELT AVE",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202118",
            "telephone_number": "505-287-2948",
            "fax_number": "505-287-5372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 E ROOSEVELT AVE",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202118",
            "telephone_number": "505-287-2948",
            "fax_number": "505-287-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUTIERREZ MEDICAL GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-287-2948",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RHIT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44636",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Benjamin Good II, DNP, CRNA
• Chandra S. Gordon, LADAC; LPC
• Grants Wellness & Rehabilitation LLC
• Grants-Cibola County Schools
• Julian Griego, BMS
• Karl R Gutierrez, MD
• Thomas J Habiger, EMT-I
• Victoria Kaylene Halbert, LPCC
• Sarah Hands, RN
• Karena Hansen, BMS

• Specialist in Grants, NM
• Providers in Grants, NM by specialty
• 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.