NPIMap

Organization Active NPI

PHC Las Cruces

Doing business as Memorial Medical Center

  • General Acute Care Hospital
  • Las Cruces, NM
National Provider Identifier
1376891010
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
282N00000X Issued in NM
Legal business name
PHC LAS CRUCES
Doing business as
Memorial Medical Center
Practice address
2450 S Telshor Blvd
Las Cruces, NM 88011-5076
Phone
(575) 532-4480
Fax
(575) 532-4463
NPI assigned
Aug 28, 2012
Last updated
Aug 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Authorized official

Name
Mr. Paul Twist
Title
Collection/Supervisor
Phone
(575) 522-8641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 282N00000X NM Primary

Addresses

Primary practice location

2450 S Telshor Blvd
Las Cruces, NM 88011-5076

Mailing address

2450 S Telshor Blvd
Las Cruces, NM 88011-5076
Phone (575) 532-4480

Other identifiers 1

IdentifierTypeStateIssuer
67939864MedicaidNM

Other names 1

  • Memorial Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
PHC Las Cruces Memorial Medical Center Family Practice Center11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2735 Northrise Dr
#2003
Las Cruces, NM 88011

2735 Northrise Dr
Ste B
Las Cruces, NM 88011
Phone (575) 532-4399

Practitioners & affiliated clinicians

Practitioners 1

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": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1376891010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115076",
            "telephone_number": "575-532-4480",
            "fax_number": "575-532-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115076",
            "telephone_number": "575-532-4480",
            "fax_number": "575-532-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC LAS CRUCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "TWIST",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "COLLECTION/SUPERVISOR",
        "authorized_official_telephone_number": "575-522-8641",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NM",
            "license": "282N00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "67939864",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.