Mora Valley Community Health Services, Inc.
Organization Active NPI Student Health Clinic/Center · Mora, NM
NPI 1396104964 · NPPES record last updated May 7, 2026
Key facts
- NPI
- 1396104964
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Student Health Clinic/Center 261QS1000X
- License
- 6333 (NM)
- Legal business name
- MORA VALLEY COMMUNITY HEALTH SERVICES, INC.
- Practice address
- 10 Ranger Rd
Mora, NM 87732-2340 - Phone
- (575) 387-3117
- NPI assigned
- Feb 11, 2016
- Organization subpart
- Yes
- Parent organization (as reported)
- MORA VALLEY COMMUNITY HEALTH SERVICES, INC
Authorized official
- Name
- Julian F Barela
- Title
- Executive Director
- Phone
- (877) 271-2202
Owners & managing parties with NPI records 1
-
Stanton C Jones, AU.D
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 1
Practitioners 17
-
Jeanne M Alvarez, FNP
-
Jessica Rose Martinez, FNP-BC
-
Martin A Ruiz, MD
-
Michael J. Lee, PA-C
-
Kelly M Young, RN, CNP
-
Krista Marie Bermejillo-Vasquez, MPAS, PA-C
-
Mauricio Lopez-Marquez, LCSW
-
Amy Weiss, CFNP
-
Roger J Ames, D.D.S.
-
Mary Bunker, CNP
-
Devon Denise Fox, RDH
-
Moriah B. Mahoney, CFNP
-
F. Elaine Montano, CFNP
-
William A Gaspar, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
Federally qualified health center certification: CCN 321947
- Legal name
- MORA VALLEY COMMUNITY HEALTH SERVICES INC
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Nov 28, 2016
- Last certification
- Nov 28, 2016
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 1, 1975 in NM
- Enrollment address
- 10 Ranger Dr
Mora, NM 87732-0209
All disclosed owners & managing parties 11
| Name | Role | Since | Share |
|---|---|---|---|
| Debbie Aragon |
Corporate Director | Feb 1, 2024 | |
| Paul H Fort |
Corporate Director | Oct 13, 2013 | |
| Samuel Muniz |
Corporate Director | Dec 13, 2010 | |
| Tobias Lovato |
Corporate Director | Mar 1, 2024 | |
| Stanton Jones |
Corporate Director | Apr 1, 2024 | |
| Rhonda Baquera |
Corporate Director | Dec 13, 2010 | |
| Selina Garcia |
Corporate Director | Jan 1, 2022 | |
| Linda Vigil |
Corporate Director | Jan 1, 2023 | |
| Charles Salazar |
Corporate Director | Dec 13, 2010 | |
| Julian F Barela |
Corporate Officer |
Oct 14, 2013 | |
| W-2 Managing Employee |
Oct 14, 2013 | ||
| Carla Melendez |
Corporate Officer |
Oct 5, 2015 | |
| W-2 Managing Employee |
Oct 5, 2015 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161212000754 | NM | Part a Provider - Federally Qualified Health Center (FQHC) | 4486541901 | Practice locations: Mora, NM |
National Provider Directory
- Tax ID family
- Mora Valley Community Health Services Inc
- Part of
- Mora Valley Community Health Services Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student Health Clinic/Center | 261QS1000X | 6333 | NM | Yes |
Addresses
Primary practice location
10 Ranger Rd
Mora, NM 87732-2340
Mailing address
PO Box 209
Mora, NM 87732-0209
Phone (575) 387-3117
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048504 | Medicaid | NM |
Other providers in Mora, NM
- Tyler E Martinez
- Mora Independent School
- Mora Valley Community Health Services
- Mora Valley Community Health Services Inc
- Mora Valley Community Health Services, Inc
- Mora Valley Community Health Services, Inc.
- Northeast Regional Education Cooperative
- Oasis Therapy, LLC
- Sasankoti Mohan Ravi Prakash
- Teresa Katherine Elaine Smith de Cherif
All providers in Mora, NM · Student Health Clinic/Center in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2026. 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.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.