Portales Medical Clinic Limited

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PORTALES MEDICAL CLINIC LIMITED

Practice address

320 S Avenue a
Portales, NM 88130-6278

Phone

(505) 356-4643

Fax

(505) 359-6856

NPI assigned

Jul 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David L Jones, NP-C

Title

Practitioner/Owner

Phone

(505) 356-4643

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1730101676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 S AVENUE A",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881306278",
            "telephone_number": "505-356-4643",
            "fax_number": "505-359-6856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 S AVENUE A",
            "city": "PORTALES",
            "state": "NM",
            "postal_code": "881306278",
            "telephone_number": "505-356-4643",
            "fax_number": "505-359-6856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTALES MEDICAL CLINIC LIMITED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "505-356-4643",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Laviece Polk
• Grace Ponto, PTA
• Portales Dental Arts Center Inc
• Portales Health Facilities LP
• Portales Home Medical Equipment Inc
• Portales Municipal Schools
• Portales Professional Compounding LLC
• William Porter
• Professional Dental Care of Southern Colorado I PLLC
• Professional Dental Care of Southern NM I PLLC

• Primary Care Clinic/Center in Portales, NM
• Providers in Portales, NM by specialty
• Primary Care Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.