Ruidoso Gastroenterology, P.C.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

95-380 Issued in NM

Legal business name

RUIDOSO GASTROENTEROLOGY, P.C.

Practice address

1701 Sudderth Dr
Ruidoso, NM 88345-6114

Phone

(575) 257-7600

Fax

(575) 257-3497

NPI assigned

Jul 21, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Victor Worthington, M.D.

Title

President

Phone

(575) 257-7600

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Michael P Clements, M.D.

  • Family Medicine Physician
  • Ruidoso, NM
  • NPI 1972668796
  NPD (past)
• Mary L Estes, CFNP

  • Family Nurse Practitioner
  • Ruidoso, NM
  • NPI 1932548153
  NPD (past)

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1568627586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 157",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883550157",
            "telephone_number": "575-257-7600",
            "fax_number": "575-257-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 SUDDERTH DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456114",
            "telephone_number": "575-257-7600",
            "fax_number": "575-257-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUIDOSO GASTROENTEROLOGY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "WORTHINGTON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "575-257-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NM",
            "license": "95-380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Romero
• Donaciano Romero
• Laura Ross
• Shannon Lee Ross
• Rosemary Roswell
• Ruidoso Home Care, LLC (Ruidoso Home Care & Hospice)
• Ruidoso Municipal Schools
• Ruidoso Physical Therapy Clinic, Inc
• Samantha R Russell, BMS
• Saguaro Dental Hygiene LLC

• Medical Specialty Clinic/Center in Ruidoso, NM
• Providers in Ruidoso, NM by specialty
• Medical Specialty Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; 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.