NPIMap

Organization Active NPI

Otero County Medical Group

  • Clinical Psychologist
  • Alamogordo, NM
National Provider Identifier
1700211323
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
OTERO COUNTY MEDICAL GROUP
Practice address
2474 Indian Wells Rd
Alamogordo, NM 88310-3845
Phone
(575) 434-6000
NPI assigned
Sep 13, 2013
Organization subpart
Yes
Parent organization
OTERO COUNTY MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Authorized official

Name
Mr. Robert James Heckert, FACHE
Title
Ceo
Phone
(575) 443-7845

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X

Addresses

Primary practice location

2474 Indian Wells Rd
Alamogordo, NM 88310-3845

Mailing address

2689 Scenic Dr
Alamogordo, NM 88310-8700
Phone (575) 434-1699

Other names 1

  • Gerald Champion Sleep Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Otero County Medical Group20 organizations share this tax ID, including this one
Part of
Otero County Medical Group

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1700211323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2689 SCENIC DR",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883108700",
            "telephone_number": "575-434-1699",
            "fax_number": "575-434-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2474 INDIAN WELLS RD",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883103845",
            "telephone_number": "575-434-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTERO COUNTY MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OTERO COUNTY MEDICAL GROUP",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "HECKERT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "575-443-7845",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "FACHE"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gerald Champion Sleep Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alamogordo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.