NPIMap

Organization Active NPI

San Miguel Hospital Corporation

  • General Acute Care Hospital
  • Las Vegas, NM
National Provider Identifier
1396716643
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
3005 Issued in NM
Legal business name
SAN MIGUEL HOSPITAL CORPORATION
Practice address
104 Legion Dr
Las Vegas, NM 87701-4804
Phone
(505) 426-3500
Fax
(505) 454-9502
NPI assigned
Jan 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Authorized official

Name
Randy Michael Cooper
Title
SVP Finance Op/Authorized Official
Phone
(615) 221-3840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 3005 NM Primary

Addresses

Primary practice location

104 Legion Dr
Las Vegas, NM 87701-4804

Mailing address

104 Legion Dr
Las Vegas, NM 87701-4804
Phone (505) 426-3500

Other identifiers 4

IdentifierTypeStateIssuer
NM000068OtherNMBCBS
76546MedicaidNM
24644OtherPHP
24622OtherPHP SALUD

Other names 1

  • Alta Vista Regional Hospital Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1396716643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 LEGION DR",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014804",
            "telephone_number": "505-426-3500",
            "fax_number": "505-454-9502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LEGION DR",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014804",
            "telephone_number": "505-426-3500",
            "fax_number": "505-454-9502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MIGUEL HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "SVP FINANCE OP/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-221-3840"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NM",
            "license": "3005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM000068",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76546",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP",
            "identifier": "24644",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP SALUD",
            "identifier": "24622",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alta Vista Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Alta Vista Regional Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.