Specialty Care Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SPECIALTY CARE CLINIC LLC

Practice address

3825 Eubank Blvd NE Ste H
Albuquerque, NM 87111-3559

Phone

(505) 350-3397

Fax

(505) 323-7980

NPI assigned

Jun 10, 2024

Organization subpart

No

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

Authorized official

Name

Mr. John K Jain

Title

Owner Ceo

Phone

(505) 350-3397

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Practitioners 3

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

• Chandran Vedamanikam, M.D.

  • Phlebology Physician
  • Albuquerque, NM
  • NPI 1154585990

  Family Medicine

  Medicare reassignment NPD
• Sarah Monzella Pack, MBA, MSN, FNP-BC

  • Family Nurse Practitioner
  • Great Falls, MT
  • NPI 1841853876

  NM

  Medicare reassignment NPD
• Julie Christine Quinonez, CERTIFIED NURSE PRAC

  • Family Nurse Practitioner
  • San Francisco, CA
  • NPI 1124277181

  NM

  Medicare reassignment NPD

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1699517771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 EUBANK BLVD NE STE H",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113559",
            "telephone_number": "505-350-3397",
            "fax_number": "505-323-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3825 EUBANK BLVD NE STE H",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113559",
            "telephone_number": "505-350-3397",
            "fax_number": "505-323-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER CEO",
        "authorized_official_telephone_number": "505-350-3397",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Susan Speaker, LCPP
• Vincent Spean
• Glenda A. Spears, LMT
• Lynda Spears
• Nancy Spears, MSW INTERN
• Monroe Spector, MD
• Spectrum Health Hub LLC
• Spectrum Support Solutions LLC
• Speech & Language a to Z, LLC
• Speech & Language a to Z, LLC

• Family Medicine Physician in Albuquerque, NM
• Providers in Albuquerque, 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 Oct 7, 2024; 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.