Active NPI
South Sound Inpatient Physicians, PLLC
- Hospitalist Physician
- Clovis, NM
National Provider Identifier
1417246539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | |||
| Internal Medicine Physician | 207R00000X | |||
| Hospitalist Physician | 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 DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
dba Sound Inpatient Physicians
- Hospitalist Physician
- Grants Pass, OR
- NPI 1780841965
Member Of
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.