Sandia Mountain Medical, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SANDIA MOUNTAIN MEDICAL, INC.

Practice address

1851 Old US 66
Unit 1
Edgewood, NM 87015-6784

Phone

(505) 286-2396

Fax

(505) 286-2398

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Victoria Gonzales

Title

Office Manager

Phone

(505) 832-4434

Specialties & licenses 2

Addresses

Other names 1

• New Mexico Medical Doing business as

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Sandia Mountain Medical, Inc.

  • Urgent Care Clinic/Center
  • Edgewood, NM
  • NPI 1497280143
  NPPES parent name

Practitioners 1

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

• Maria Fernanda Garcia Ortiz, PA-C

  • Medical Physician Assistant
  • Albuquerque, NM
  • NPI 1114603115

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1609885243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12127B HWY 14 N STE 5",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870089499",
            "telephone_number": "505-286-2396",
            "fax_number": "505-286-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 OLD US 66",
            "address_2": "UNIT 1",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870156784",
            "telephone_number": "505-286-2396",
            "fax_number": "505-286-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDIA MOUNTAIN MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "GONZALES",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-832-4434"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Mexico Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carla Rudolph, DO
• Matthew Paul Sanchez, MOTR/L
• Melynda D Sanchez
• Sidney Sanchez
• Sandia Mountain Medical, Inc.
• Saverio Joseph Sava, MD
• Andrew H Schlosser, OT
• Kara Nicole Shrader, LPCC
• Korey Shrader, LMHC
• Matthew Shultz, DPT

• Family Medicine Physician in Edgewood, NM
• Providers in Edgewood, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; 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.