Rio Grande Emergency Medicine PA

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

RIO GRANDE EMERGENCY MEDICINE PA

Practice address

2450 S Telshor Blvd
Las Cruces, NM 88011-5069

Phone

(706) 354-5770

Fax

(706) 354-5769

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Kelly Willoughby

Title

Credentialing

Phone

(706) 354-5770

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Radosveta N. Wells, MD

  • Emergency Medicine Physician
  • Las Cruces, NM
  • NPI 1568594224
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1518063643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5719",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306045719",
            "telephone_number": "706-354-5770",
            "fax_number": "706-354-5769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "706-354-5770",
            "fax_number": "706-354-5769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO GRANDE EMERGENCY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "WILLOUGHBY",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "706-354-5770"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78138701",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tina Kay Richardson, LPCC
• Dina Rico
• Lynn E Riggs
• Kacey Kay Rikard
• Bonnie Lynn Rinkels, RDH
• Rio Grande Foot Clinic Inc
• Rio Grande Hearing Center
• Rio Grande Hematology and Oncology, LLC
• Rio Grande Medical Group
• Rio Grande Medical Group, LTD

• Emergency Medicine Physician in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Emergency Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; 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.