NPIMap

Organization Active NPI

Presbyterian Healthcare Services

Doing business as Lincoln County Medical Center

  • Critical Access Hospital
  • Ruidoso, NM
National Provider Identifier
1558347708
Registry record updated Oct 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
3199 Issued in NM
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
Lincoln County Medical Center
Practice address
211 Sudderth Dr
Ruidoso, NM 88345-6002
Phone
(505) 257-7381
Fax
(505) 630-4233
NPI assigned
Dec 20, 2005
Last updated
Oct 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2016

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

Authorized official

Name
Mr. Bo Beames
Title
VP Regional Operations
Phone
(505) 923-5339

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X
Internal Medicine Physician 207R00000X
Critical Access Hospital 282NC0060X 3199 NM Primary
Land Ambulance 3416L0300X 3199 NM

Addresses

Primary practice location

211 Sudderth Dr
Ruidoso, NM 88345-6002

Mailing address

PO Box 26666
Provider Enrollment
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 2

IdentifierTypeStateIssuer
00521MedicaidNM
2256807OtherNMPART B

Other names 1

  • Lincoln County Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031103000603 NM Part B Supplier - Clinic/Group Practice 9234041708 Receives reassigned benefits from 2,628 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
O20090316000666 NM Part A Provider - Critical Access Hospital 9234041708 Receives reassigned benefits from 223 practitioners
Practice locations: Ruidoso, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1558347708. Details of each certification follow.

Hospital certification: CCN 321306

Legal name
PRESBYTERIAN HEALTHCARE SERVICES
Doing business as
LINCOLN COUNTY MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 20, 2004
Last certification
Sep 1, 2023
Beds
25
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
in NM
Enrollment address
211 Sudderth Dr
Ruidoso, NM 88345-6002
Other Hospital Practice Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Lincoln County Medical CenterCCN 321306 · All quality measures
Overall star rating
2 of 5
Type
Critical Access Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D0653322Lincoln County Medical Center Laboratory211 Sudderth Drive, Ruidoso, NM 88345AccreditationJan 2, 2027

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kimberly Poland Individual W-2 Managing EmployeeManager Provider Enrollment Jan 1, 2011
Operational/Managerial ControlManager Provider Enrollment Jan 1, 2011
Steven Figge Individual Corporate DirectorDirector Mso Jan 1, 2010

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Presbyterian Espanola HospitalEspanola, NM, CCN 320011 Hospital Operational/Managerial Control May 24, 1948
Plains Regional Medical Center ClovisClovis, NM, CCN 320022 Hospital Operational/Managerial Control Jan 1, 1978
Socorro General HospitalSocorro, NM, CCN 32Z301 Hospital Operational/Managerial Control Mar 30, 2000
Socorro General HospitalSocorro, NM, CCN 321301 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 321302 Hospital Operational/Managerial Control Mar 30, 2000
Dr. Dan C. Trigg Memorial HospitalTucumcari, NM, CCN 32Z302 Hospital Operational/Managerial Control Mar 15, 2000
Socorro General Hospital Home HealthcareSocorro, NM, CCN 327027 Home health agency 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 1, 2000
Jan 19, 2009
Plains Regional Medical Center Clovis Home HealthcareClovis, NM, CCN 327305 Home health agency 5% Or Greater Direct Ownership Interest Feb 14, 1979
Tucumcari HospiceTucumcari, NM, CCN 321566 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Dec 1, 2009
Dec 1, 2009

Practitioners & affiliated clinicians

Practitioners 282

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.

View all 282

Affiliated clinicians 171

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 171

NPI Registry JSON

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1558347708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 SUDDERTH DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456002",
            "telephone_number": "505-257-7381",
            "fax_number": "505-630-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "BEAMES",
        "authorized_official_first_name": "BO",
        "authorized_official_title_or_position": "VP REGIONAL OPERATIONS",
        "authorized_official_telephone_number": "505-923-5339",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "NM",
            "license": "3199",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NM",
            "license": "3199",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00521",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PART B",
            "identifier": "2256807",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln County Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ruidoso, NM

Sources for this page

Verify at the official NPI Registry.