NPIMap

Organization Active NPI

San Juan Regional Medical Center Inc

Doing business as SJHP Gastroenterology

  • Gastroenterology Physician
  • Farmington, NM
National Provider Identifier
1639662901
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
SAN JUAN REGIONAL MEDICAL CENTER INC
Doing business as
SJHP Gastroenterology
Practice address
630 W Maple St
Farmington, NM 87401-6113
Phone
(505) 609-6349
Fax
(505) 599-4679
NPI assigned
Jun 12, 2018
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SAN JUAN REGIONAL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Kim R Hipsher-Byrd
Title
Administrative Director of Reimburs
Phone
(505) 609-2258

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

630 W Maple St
Farmington, NM 87401-6113

Mailing address

PO Box 844088
Dallas, TX 75284-4088
Phone (505) 609-2258

Other names 1

  • SJHP GASTROENTEROLOGY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000865 NM Part B Supplier - Clinic/Group Practice 4587559505 Receives reassigned benefits from 396 practitioners
18 other NPIs on this enrollment
Practice locations: Farmington, NM; Bloomfield, NM; Aztec, NM

Other NPIs with the same Medicare PAC ID 3

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

Other NPIs on the same Medicare enrollment 18

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

View all 18

National Provider Directory

National Provider Directory
Part of
San Juan Hospital

Practitioners & affiliated clinicians

Practitioners 409

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 409

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1639662901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844088",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844088",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874016113",
            "telephone_number": "505-609-6349",
            "fax_number": "505-599-4679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN JUAN REGIONAL MEDICAL CENTER INC",
        "enumeration_date": "2018-06-12",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "HIPSHER-BYRD",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR OF REIMBURS",
        "authorized_official_telephone_number": "505-609-2258"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJHP GASTROENTEROLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SJHP GASTROENTEROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.