Colonias Chiropractic Center Inc
Organization Active NPI Chiropractor · El Prado, NM
NPI 1356555262 · NPPES record last updated Jul 21, 2010
Key facts
- NPI
- 1356555262
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1149 (NM)
- Legal business name
- COLONIAS CHIROPRACTIC CENTER INC
- Practice address
- 98 State Hwy 150 Suite #7
El Prado, NM 87529 - Phone
- (575) 776-1117
- Fax
- (575) 776-1119
- NPI assigned
- May 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Lucy Whyte Ferguson, D.C.
- Title
- Owner
- Phone
- (505) 776-1117
Practitioners 15
-
Lucy Whyte Ferguson, D.C.
-
Andrea Whyte Griffin, D.C.
-
Andrea Maureen Ignacio, D.C.
-
Brian F Flynn, LMT
-
Cali Elizabeth Henderson, RN, LMT
-
Andra E. Maddox, LMT
-
Hannah Marie Pierce, L.M.T.
-
Devin K Powell, LMT
-
Arthur William Lynch III, M.D.
-
Amy Marie Vaughn, DC
-
Darcy M Ward, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090825000194 | NM | Part B Supplier - Clinic/Group Practice | 2466506530 |
Receives reassigned benefits from 5 practitioners Practice locations: El Prado, NM |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 1149 | NM | Yes |
Addresses
Primary practice location
98 State Hwy 150 Suite #7
El Prado, NM 87529
Mailing address
PO Box 1589
El Prado, NM 87529-1589
Phone (575) 776-1117
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM01KB78 | Other | NM | BLUE CROSS BLUE SHIELD |
Other providers in El Prado, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.