Four Corners Heart and Lung Institute PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

MD2008-0311 Issued in NM

Legal business name

FOUR CORNERS HEART AND LUNG INSTITUTE PC

Practice address

2700 Farmington Ave
Building I Suite 2
Farmington, NM 87401-4559

Phone

(505) 326-3691

Fax

(505) 327-9688

NPI assigned

Jan 27, 2011

Last updated

Jun 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Robert Frederick Sprung, MDNPI 1255314837

Title

Ceo

Phone

(801) 450-3851

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert F. Sprung Jr., M.D.

  • Specialist
  • Farmington, NM
  • NPI 1255314837
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1477859122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 FARMINGTON AVE",
            "address_2": "BUILDING I SUITE 2",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874014559",
            "telephone_number": "505-326-3691",
            "fax_number": "505-327-9688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 FARMINGTON AVE",
            "address_2": "BUILDING I SUITE 2",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874014559",
            "telephone_number": "505-326-3691",
            "fax_number": "505-327-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS HEART AND LUNG INSTITUTE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "SPRUNG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-450-3851",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NM",
            "license": "MD2008-0311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86532031",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "NM301033",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Four Corners Artificial Limb & Brace
• Four Corners Compounding
• Four Corners Family Dental LLC
• Four Corners Foot and Ankle P.C.
• Four Corners Gastroenterology Consultants PC
• Four Corners Medical LLC
• Four Corners Muscle and Nerve Center PC
• Four Corners Nephrology Associates PC
• Four Corners Oriental Medicine and Acupuncture, LLC
• Four Corners Orthodontics Centers Inc

• Medical Specialty Clinic/Center in Farmington, NM
• Providers in Farmington, NM by specialty
• Medical Specialty Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.