Active NPI
San Miguel Hospital Corporation
Doing business as Alta Vista Regional Hospital
- Medicare Defined Swing Bed Hospital Unit
- Las Vegas, NM
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medicare Defined Swing Bed Hospital Unit
- Legal business name
- SAN MIGUEL HOSPITAL CORPORATION
- Doing business as
- Alta Vista Regional Hospital
- Practice address
- 104 Legion Dr
Las Vegas, NM 87701-4804 - Phone
- (505) 426-3500
- NPI assigned
- Oct 30, 2023
- Last updated
- Oct 30, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Laura J Fey
- Title
- VP Physician Practices
- Phone
- (615) 221-3641
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | Primary |
Addresses
Primary practice location
104 Legion Dr
Las Vegas, NM 87701-4804
Mailing address
1573 Mallory LN Ste 100
Brentwood, TN 37027-2895
Phone (615) 221-3722
Other names 1
- ALTA VISTA REGIONAL HOSPITAL
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20231025001625 | NM | Part A Provider - Hospital | 8921097502 |
1 other NPI on this enrollment Practice locations: Las Vegas, NM |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1598537862. Details of each certification follow.
Hospital certification: CCN 32Z312
- Legal name
- SAN MIGUEL HOSPITAL CORPORATION
- Organization structure
- Corporation
- Enrollment address
- 104 Legion Dr
Las Vegas, NM 87701-4804 - Hospital subgroups
- Swing-bed approved
Related certifications (CCN) 1
Facilities connected through Provider of Services related, parent or unit certification numbers.
-
dba Alta Vista Regional Hospital
- Critical Access Hospital
- Las Vegas, NM
- NPI 1114639234
Unit of hospital
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba Alta Vista Regional Hospital
- Critical Access Hospital
- Las Vegas, NM
- NPI 1114639234
8921097502
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Alta Vista Regional Hospital
- Critical Access Hospital
- Las Vegas, NM
- NPI 1114639234
O20231025001625
National Provider Directory
National Provider DirectoryLocations
104 Legion Dr
Ste 100
Las Vegas, NM 87701
Phone (505) 426-3500
Ownership & related parties
All disclosed owners & managing parties 18
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Davidson Kempner Distressed Opportunities International Cayman | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 11.6% |
| Henry Kunath | Corporate Officer | Sep 6, 2023 | |
| Corporate Director | Sep 6, 2023 | ||
| DK Distressed Opportunities Int LTD | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 13.2% |
| DK Ldoi IV Aggregate Holdco LP | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 11.8% |
| Davidson Kempner Long-Term Distressed Opportunities Fund IV L | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 6.1% |
| Quorum Health Corporation | 5% Or Greater Direct Ownership Interest | Apr 29, 2016 | 100% |
| DK Quincy Investor BT I LLC | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 7.9% |
| Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 11.8% |
| Goldentree Distressed Onshore Master Fund III LP | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 6.8% |
| DK Quincy Investor BT II LLC | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 7.9% |
| Laura Fey | Corporate Director | Aug 27, 2018 | |
| W-2 Managing Employee | Aug 27, 2018 | ||
| Goldentree Select Offshore Intermediate Fund LP | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 5.44% |
| Goldentree Distressed Master Fund III LTD | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 11% |
| Quincy Health LLC | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 100% |
| Steven W Frantz | Corporate Officer | Aug 10, 2022 | |
| Corporate Director | Aug 10, 2022 | ||
| Julie Manas | Corporate Officer | Aug 10, 2022 | |
| Corporate Director | Aug 10, 2022 | ||
| Davidson Kempner Distressed Opportunities Fund LP | 5% Or Greater Indirect Ownership Interest | Jul 7, 2020 | 7.8% |
| Donald Esposito | Corporate Officer | Sep 16, 2021 | |
| Corporate Director | Sep 16, 2021 |
Facilities with the same owner 36
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Mimbres Valley Medical Group
- Rural Health Clinic/Center
- Deming, NM
- NPI 1134526221
Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation
-
dba Mimbres Memorial Hospital
- Medicare Defined Swing Bed Hospital Unit
- Deming, NM
- NPI 1710196571
Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation
-
dba Mimbres Memorial Hospital
- Critical Access Hospital
- Deming, NM
- NPI 1891075446
Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation
-
- Rural Health Clinic/Center
- Alpine, TX
- NPI 1275988669
Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation
-
dba Big Bend Regional Medical Center
- Critical Access Hospital
- Alpine, TX
- NPI 1356312243
Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation
-
dba Big Bend Regional Medical Center
- Medicare Defined Swing Bed Hospital Unit
- Alpine, TX
- NPI 1689773756
Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation
-
dba Scenic Mountain Medical Center
- General Acute Care Hospital
- Big Spring, TX
- NPI 1336976034
Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation
-
dba Scenic Mountain Medical Center
- Psychiatric Hospital Unit
- Big Spring, TX
- NPI 1770310476
Goldentree Distressed Master Fund III LTD, Goldentree Distressed Onshore Master Fund III LP, Goldentree Select Offshore Intermediate Fund LP, Quincy Health LLC, Quorum Health Corporation
-
dba Community Hospital of Huntington Park
- General Acute Care Hospital
- Huntington Park, CA
- NPI 1891059127
Davidson Kempner Long-Term Distressed Opportunities Fund IV L, Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP, DK Ldoi IV Aggregate Holdco LP
-
dba Coast Plaza Hospital
- General Acute Care Hospital
- Norwalk, CA
- NPI 1194016923
Davidson Kempner Long-Term Distressed Opportunities Fund IV L, Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP, DK Ldoi IV Aggregate Holdco LP
-
dba East Los Angeles Doctors Hospital
- Skilled Nursing Facility
- Los Angeles, CA
- NPI 1720298326
Davidson Kempner Long-Term Distressed Opportunities Fund IV L, Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP, DK Ldoi IV Aggregate Holdco LP
-
dba Bridger Valley Medical Group
- Rural Health Clinic/Center
- Lyman, WY
- NPI 1134666944
Davidson Kempner Distressed Opportunities Fund LP, Davidson Kempner Distressed Opportunities International Cayman, Davidson Kempner Long-Term Distressed Opportunities Fund IV L, Davidson Kempner Long-Term Distressed Opps Intl IV Aiv LP, DK Distressed
Practitioners & affiliated clinicians
Practitioners 22
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.
-
- Internal Medicine Physician
- Las Vegas, NM
- NPI 1497708754
-
- Internal Medicine Physician
- Las Vegas, NM
- NPI 1659375194
-
- Family Nurse Practitioner
- Las Vegas, NM
- NPI 1497492912
-
- Family Nurse Practitioner
- Greenwood Village, CO
- NPI 1306389846
-
- Internal Medicine Physician
- New Braunfels, TX
- NPI 1538262407
-
- Family Nurse Practitioner
- Washington, DC
- NPI 1235291394
-
- Anesthesiology Physician
- Albuquerque, NM
- NPI 1457577231
-
- Certified Registered Nurse Anesthetist
- Alamogordo, NM
- NPI 1295734341
-
- Anesthesiology Physician
- Lovington, NM
- NPI 1376645598
-
- Obstetrics & Gynecology Physician
- Las Vegas, NM
- NPI 1619904729
-
- Certified Registered Nurse Anesthetist
- Las Vegas, NM
- NPI 1285736314
-
- Neurology with Special Qualifications in Child Neurology Physician
- Las Vegas, NM
- NPI 1710086749
Affiliated clinicians 2
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Henderson, NC
- NPI 1265905780
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698624000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1698624000000",
"number": "1598537862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1573 MALLORY LN STE 100",
"city": "BRENTWOOD",
"state": "TN",
"postal_code": "370272895",
"telephone_number": "615-221-3722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 LEGION DR",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014804",
"telephone_number": "505-426-3500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAN MIGUEL HOSPITAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2023-10-30",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A",
"authorized_official_last_name": "FEY",
"authorized_official_first_name": "LAURA",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "VP PHYSICIAN PRACTICES",
"authorized_official_telephone_number": "615-221-3641",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "275N00000X",
"taxonomy_group": "",
"desc": "Medicare Defined Swing Bed Unit",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ALTA VISTA REGIONAL HOSPITAL",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Las Vegas, NM
- San Miguel Dental
- San Miguel Emergency Group LLC
- San Miguel Hospital Corporation (Alta Vista Regional Hospital)
- San Miguel Hospital Corporation (Alta Vista Regional Hospital)
- San Miguel Hospital Corporation (Alta Vista Regional Hospital)
- San Miguel Hospital Corporation (Alta Vista Regional Hospital)
- San Miguel Physician Services LLC
- Sanchez Dental LLC
- Alicia Sanchez, LMHC
- Frank Leonardo Sanchez, DDS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.