Randal Warren Brown, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

93-226 Issued in NM

Practice address

117 Camino de Vida
Suite 300
Santa Rosa, NM 88435-2267

Phone

(505) 472-4311

Fax

(505) 472-4313

NPI assigned

Oct 2, 2006

Last updated

Apr 12, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 10

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Helping Hands Hospice

  • Community Based Hospice Care Agency
  • Tucumcari, NM
  • NPI 1891849154

  W-2 Managing Employee

  CMS ownership
• Sunrise Clinics

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, NM
  • NPI 1164055927

  Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• Sunrise Clinics

  dba Sunrise Clinics - WLV Middle/High SBHC

  • Student Health Clinic/Center
  • Las Vegas, NM
  • NPI 1194408625

  Corporate Officer

  CMS ownership
• Sunrise Clinics

  dba Sunrise Clinics - NMHU

  • Federally Qualified Health Center (FQHC)
  • Las Vegas, NM
  • NPI 1376326942

  Corporate Officer

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sunrise Clinics

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, NM
  • NPI 1164055927

  Family Medicine

  Medicare reassignment NPD Authorized official
• Guadalupe County

  dba Guadalupe County Hospital

  • Emergency Care Clinic/Center
  • Santa Rosa, NM
  • NPI 1346249968
  Medicare reassignment NPD
• Emergency Staffing Solutions Inc

  • Emergency Medicine Physician
  • Many, LA
  • NPI 1477590974

  NM

  Medicare reassignment NPD
• Ess Hospitalist LLC

  • Hospitalist Physician
  • Crossett, AR
  • NPI 1881967305

  NM

  Medicare reassignment NPD
• Guadalupe County

  dba Guadalupe County Ambulance Service

  • Land Ambulance
  • Santa Rosa, NM
  • NPI 1063227494
  NPD
• Helping Hands Hospice

  • Community Based Hospice Care Agency
  • Tucumcari, NM
  • NPI 1891849154

  Family Medicine

  NPD
• Santa Rosa Medical Clinic

  • Internal Medicine Physician
  • Santa Rosa, NM
  • NPI 1922039171
  NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1376636159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 CAMINO DE VIDA",
            "address_2": "STE 300",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352267",
            "telephone_number": "505-472-4311",
            "fax_number": "505-472-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CAMINO DE VIDA",
            "address_2": "SUITE 300",
            "city": "SANTA ROSA",
            "state": "NM",
            "postal_code": "884352267",
            "telephone_number": "505-472-4311",
            "fax_number": "505-472-4313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RANDAL",
        "middle_name": "WARREN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "93-226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02871",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jolene J Archuleta, BMS
• Benjamin Cruz Arenas, PHARM.D.
• Dawn R Back, PA
• Nicole Barela, BMS
• Desiree Bradley
• Larissa Marie Campos
• Senora L Campos
• Sharon Campos, BMS
• Andrea Chavez, BMS
• Mary Jane Chavez, CHW

• Family Medicine Physician in Santa Rosa, NM
• Providers in Santa Rosa, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.