NPIMap

Organization Active NPI

Guadalupe Psychiatric and Mental Health Services

  • Psychiatry Physician
  • Rio Rancho, NM
National Provider Identifier
1699091389
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20030591 Issued in NM
Legal business name
GUADALUPE PSYCHIATRIC AND MENTAL HEALTH SERVICES
Practice address
1005 21St St SE
Ste 7
Rio Rancho, NM 87124-4030
Phone
(505) 459-6101
NPI assigned
Apr 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Yvonne D Hall, MDNPI 1922029164
Title
Sole Owner
Phone
(505) 459-6101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X 20030591 NM Primary

Addresses

Primary practice location

1005 21St St SE
Ste 7
Rio Rancho, NM 87124-4030

Mailing address

2003 Southern Blvd SE Ste 102-214
Rio Rancho, NM 87124-3751
Phone (505) 459-6101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110126000258 NM Part B Supplier - Clinic/Group Practice 5496934291 Receives reassigned benefits from 2 practitioners
Practice locations: Albuquerque, NM; Rio Rancho, NM; Los Lunas, NM

National Provider Directory

National Provider Directory

Locations

3901 Georgia St NE
Ste C1
Albuquerque, NM 87110
Phone (505) 515-3982

431 Luna Ave SE
Ste C
Los Lunas, NM 87031
Phone (505) 515-3982

1005 21st St SE
Ste 7
Rio Rancho, NM 87124
Phone (505) 459-6101

2003 Southern Blvd SE
Ste 102214
Rio Rancho, NM 87124

1350 Jackie Rd SE
Ste 104
Rio Rancho, NM 87124
Phone (505) 238-2997

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1699091389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 SOUTHERN BLVD SE STE 102-214",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871243751",
            "telephone_number": "505-459-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 21ST ST SE",
            "address_2": "STE 7",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871244030",
            "telephone_number": "505-459-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUADALUPE PSYCHIATRIC AND MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "505-459-6101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NM",
            "license": "20030591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.