Pecos Valley Medical Center, Inc

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

License

6263 Issued in NM

Legal business name

PECOS VALLEY MEDICAL CENTER, INC

Practice address

199 Hwy 50
Pecos, NM 87552-0710

Phone

(505) 757-6482

Fax

(505) 757-2700

NPI assigned

Jan 26, 2007

Last updated

Sep 22, 2015By 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

Mr. Kevin Norris

Title

Cfo

Phone

(505) 757-6482

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Pecos Valley Medical Center, Inc

  dba Pecos Valley Medical Center, Inc Teen School Based Clinic

  • Student Health Clinic/Center
  • Pecos, NM
  • NPI 1386143352
  NPPES parent name

Practitioners 2

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.

• Caitlin Thomas, CNP

  • Family Nurse Practitioner
  • Pecos, NM
  • NPI 1437653060
  Medicare reassignment NPD
• Lucien David Young, D.O.

  • Internal Medicine Physician
  • Pecos, NM
  • NPI 1730150178
  Medicare reassignment

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1497801047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "city": "PECOS",
            "state": "NM",
            "postal_code": "875520710",
            "telephone_number": "505-757-6482",
            "fax_number": "505-757-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 HWY 50",
            "city": "PECOS",
            "state": "NM",
            "postal_code": "875520710",
            "telephone_number": "505-757-6482",
            "fax_number": "505-757-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECOS VALLEY MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "NORRIS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "505-757-6482",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": "NM",
            "license": "6263",
            "primary": true
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "NM",
            "license": "CL00007120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Pack, MA, OTRL
• Pecos Independent School District
• Pecos Valley Ambulance Service
• Pecos Valley Ambulance Service
• Pecos Valley Medical Center, Inc (Pecos Valley Medical Center, Inc Teen School Based Clinic)
• Richard C Peters, DDS
• Pilar Healthcare LLC
• Presbyterian Medical Services (PMS-Pecos Valley Medical Center)
• Presbyterian Medical Services (Pecos Valley Medical Center)
• Claudia Quan, DDS

• Community Health Clinic/Center in Pecos, NM
• Providers in Pecos, NM by specialty
• Community Health Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.