NPIMap

Organization Active NPI

Lovelace Health System LLC

  • Rural Health Clinic/Center
  • Roswell, NM
National Provider Identifier
1609273283
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
LOVELACE HEALTH SYSTEM LLC
Practice address
1112 N Main St
Roswell, NM 88201-5010
Phone
(575) 627-4200
Fax
(575) 627-4212
NPI assigned
Nov 26, 2014
Organization subpart
Yes
Parent organization
ARDENT LEGACY HOLDINGS, LLCAs reported in NPPES

Authorized official

NPPES NPI Registry
Name
Stephen C Petrovich
Title
Evp
Phone
(615) 296-3000

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs on the same Medicare enrollment 13

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

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Facilities with the same owner 61

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 61

Practitioners 20

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

Medicare participation

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

Rural health clinic certification: CCN 323403

Medicare enrollment files
Legal name
LOVELACE HEALTH SYSTEM LLC
Doing business as
LOVELACE REGIONAL HOSPITAL-ROSWELL
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
May 18, 2016
Last certification
May 7, 2025
Ownership / control type
1B
Organization structure
CorporationProprietary
Incorporated
Oct 29, 1984 in NM
Enrollment address
1112 N Main St
Roswell, NM 88201-5010
Related CCNs
320086

All disclosed owners & managing parties 8

Medicare enrollment files

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

NameRoleSinceShare
Ardent Health Inc Organization, Nashville, TN LLC 5% Or Greater Indirect Ownership Interest Jan 1, 2019 100%
Martin Bonick Individual Corporate OfficerCeo-Chain Office Aug 16, 2020
Mary a Crabtree Individual Corporate OfficerVice President Mar 1, 2014
Ahs Management Company Inc. Organization, Nashville, TN Corporation Operational/Managerial Control Jan 1, 2019 100%
Stephen C Petrovich Individual Corporate OfficerSVP General Counsel and Secretar Mar 1, 2014
Matt Maxfield Individual Corporate OfficerPresident and Ceo Jul 1, 2022 100%
W-2 Managing EmployeePresident and Ceo Jul 1, 2022 100%
Ardent Legacy Holdings LLC Organization, Nashville, TN LLC 5% Or Greater Direct Ownership Interest Jan 1, 2019 100%
Ahp Health Partners, Inc Organization, Nashville, TN Corporation 5% Or Greater Indirect Ownership Interest Jan 1, 2019 100%

All facility ownership & control disclosures 2

Medicare enrollment files

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

FacilityTypeRoleSince
Lovelace Unm Rehabilitation HospitalAlbuquerque, NM, CCN 323028 Hospital 5% Or Greater Direct Ownership Interest (51%)
5% Or Greater Security Interest (51%)
Operational/Managerial Control (51%)		 May 1, 2017
May 1, 2017
May 1, 2017
Lovelace Health Care Center-UnionRoswell, NM, CCN 323859 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 17, 2023

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20031210000397 NM Part B Supplier - Clinic/Group Practice 9739099326 Receives reassigned benefits from 65 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Roswell, NM; Albuquerque, NM
O20150303002126 NM Part a Provider - Rural Health Clinic 9739099326 Practice locations: Roswell, NM

National Provider Directory

National Provider Directory

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

NPPES NPI Registry

Primary practice location

1112 N Main St
Roswell, NM 88201-5010

Mailing address

1 Burton Hills Blvd
Suite 250
Nashville, TN 37215-6293
Phone (615) 296-3000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 30, 2019.

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1609273283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BURTON HILLS BLVD",
            "address_2": "SUITE 250",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156293",
            "telephone_number": "615-296-3000",
            "fax_number": "615-296-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 N MAIN ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015010",
            "telephone_number": "575-627-4200",
            "fax_number": "575-627-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVELACE HEALTH SYSTEM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARDENT LEGACY HOLDINGS, LLC",
        "enumeration_date": "2014-11-26",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "615-296-3000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.