Organization Active NPI

South Sound Inpatient Physicians, PLLC

  • Hospitalist Physician
  • Clovis, NM
National Provider Identifier
1417246539
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
Legal business name
SOUTH SOUND INPATIENT PHYSICIANS, PLLC
Practice address
2100 N Dr Martin Luther King Jr Blvd
Clovis, NM 88101-9412
Phone
(575) 769-2141
NPI assigned
Mar 29, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Authorized official

Name
James Kodjababian
Title
Cro
Phone
(253) 682-1710

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X Primary

Addresses

Primary practice location

2100 N Dr Martin Luther King Jr Blvd
Clovis, NM 88101-9412

Mailing address

1123 Pacific Ave
Tacoma, WA 98402-4303
Phone (253) 682-1710

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2100 N Mlk Blvd
Clovis, NM 88101
Phone (505) 769-2141

NPI Registry JSON

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

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1417246539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1123 PACIFIC AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024303",
            "telephone_number": "253-682-1710",
            "fax_number": "253-284-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N DR MARTIN LUTHER KING JR BLVD",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881019412",
            "telephone_number": "575-769-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SOUND INPATIENT PHYSICIANS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "KODJABABIAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "253-682-1710"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.