NPIMap

Organization Active NPI

Sandia Mountain Medical, Inc.

Doing business as New Mexico Medical Urgent Care

  • Urgent Care Clinic/Center
  • Edgewood, NM
National Provider Identifier
1497280143
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
02478 Issued in NM
Legal business name
SANDIA MOUNTAIN MEDICAL, INC.
Doing business as
New Mexico Medical Urgent Care
Practice address
104 Quail TRL Unit B
Edgewood, NM 87015-7185
Phone
(505) 281-5180
NPI assigned
May 1, 2017
Last updated
May 12, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
SANDIA MOUNTAIN MEDICAL, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Authorized official

Name
James Marc BeverlyNPI 1215245287
Title
Coo/ Owner
Phone
(505) 281-5180

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X 02478 NM Primary

Addresses

Primary practice location

104 Quail TRL Unit B
Edgewood, NM 87015-7185

Mailing address

12127B Hwy 14 N Ste 5
Cedar Crest, NM 87008
Phone (505) 281-5180

Other names 1

  • New Mexico Medical Urgent Care Doing business as

National Provider Directory

National Provider Directory
Part of
Sandia Mountain Medical Inc

Locations

3 George Ct
Ste C
Edgewood, NM 87015
Phone (505) 286-2396

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1497280143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12127B HWY 14 N STE 5",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "87008",
            "telephone_number": "505-281-5180",
            "fax_number": "505-281-5320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 QUAIL TRL UNIT B",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870157185",
            "telephone_number": "505-281-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDIA MOUNTAIN MEDICAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANDIA MOUNTAIN MEDICAL, INC",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "BEVERLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "COO/ OWNER",
        "authorized_official_telephone_number": "505-281-5180"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NM",
            "license": "02478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Mexico Medical Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Edgewood, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; 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.