Individual provider Active NPI

Mary Ann McGuire, CFNP

  • Family Medicine Physician
  • Roswell, NM
National Provider Identifier
1417958711
Registry record updated Mar 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R38408 Issued in NM
Practice address
1627 S Union Ave
Roswell, NM 88203-2656
Phone
(575) 208-0106
Fax
(575) 208-0700
NPI assigned
Aug 9, 2005
Last updated
Mar 22, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R38408 NM Primary

Addresses

Primary practice location

1627 S Union Ave
Roswell, NM 88203-2656

Mailing address

1717 W 2ND St
Ste 101
Roswell, NM 88201-2000
Phone (575) 627-1200

Other identifiers 7

IdentifierTypeStateIssuer
R6548MedicaidNM
79619OtherNMPRESBYTERIAN
MARYANNMCGUIREOtherTRICARE
110162385OtherRR MEDICARE
87726OtherUNITED HEALTH CARE
841627609OtherHEALTHSMART
NM011928OtherNMBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R38408NMMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roswell Hospital Corporation Past Accepting new patients
Roswell Clinic Corp Family Medicine Past Accepting new patients
Muglin LLC Past Accepting new patients
Roswell Hospital Corporation Family Medicine Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1417958711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W 2ND ST",
            "address_2": "STE 101",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882012000",
            "telephone_number": "575-627-1200",
            "fax_number": "888-445-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 S UNION AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882032656",
            "telephone_number": "575-208-0106",
            "fax_number": "575-208-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "MARY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CFNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "R38408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R6548",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN",
            "identifier": "79619",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "MARYANNMCGUIRE",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "110162385",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "87726",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSMART",
            "identifier": "841627609",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM011928",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.