Reliance Medical Group LLC

Key facts

NPI: 1497851208
Entity type: Organization (NPI type 2)
Primary specialty: Urgent Care Clinic/Center 261QU0200X
Legal business name: RELIANCE MEDICAL GROUP LLC
Practice address: 3451 N Butler Ave
Farmington, NM 87401
Phone: (505) 566-1915
Fax: (505) 566-1918
NPI assigned: Sep 16, 2006
Organization subpart: No

Authorized official

Name: Mr. James L Holgate
Title: Vice President
Phone: (505) 566-1915

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.

Sage Family Medicine Family Medicine Physician · Farmington, NM · NPI 1477720035

NPPES parent name

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Kami Olguin, NP Family Nurse Practitioner · Farmington, NM · NPI 1225823255

Medicare reassignment NPD NM
Kennard Stradling, MD Emergency Medicine Physician · Farmington, NM · NPI 1548236953

Medicare reassignment NPD NM
Larry Ray Welling, M.D. Occupational Medicine Physician · Farmington, NM · NPI 1720183874

Medicare reassignment NPD NM
Douglas Eugene Shaffer, PAC Medical Physician Assistant · Farmington, NM · NPI 1639225055

Medicare reassignment NM
Kaarlo Alakoski, PA-C Physician Assistant · Farmington, NM · NPI 1508897455

NPD
Ronald D Tiller, PA-C Physician Assistant · St George, UT · NPI 1881630572

NPD (past)

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
32D1085356	Reliance Medical Group LLC 3451 N Butler Ave, Farmington, NM 87401	Certificate of waiver	Jun 15, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NM

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20040818000082	NM	Part B Supplier - Clinic/Group Practice	9537132543	Receives reassigned benefits from 4 practitioners Practice locations: Farmington, NM

National Provider Directory

Locations

511 E 20th St
Farmington, NM 87401
Phone (505) 564-3733

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Urgent Care Clinic/Center	261QU0200X			Yes

Addresses

Primary practice location

3451 N Butler Ave
Farmington, NM 87401

Mailing address

3451 N Butler Ave
Farmington, NM 87401-2357
Phone (505) 566-1915

Other identifiers

Identifier	Type	State	Issuer
27856721	Medicaid	NM

Other providers in Farmington, NM

Mary A Reinhardt, M.A., CCC-SLP
Alyssa Anne Reiser, CSW
Shawna Lisa Reiter, LCSW
Christopher Gary Reitmeier, CRNA
Reliance Chiropractic
Michelle Renaud
Resource Anesthesiology Associates of NM Inc
Chanelle Reynolds
Christian Ray Reynolds, BS, MS, DMD
Pauline Reynolds

All providers in Farmington, NM · Urgent Care Clinic/Center in New Mexico

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.