NPIMap

Organization Active NPI

St Vincent Hospital

Doing business as CHRISTUS St. Vincent Medical Specialty Clinic

  • Family Medicine Physician
  • Santa Fe, NM
National Provider Identifier
1770146391
Registry record updated Apr 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST VINCENT HOSPITAL
Doing business as
CHRISTUS St. Vincent Medical Specialty Clinic
Practice address
433 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone
(505) 988-1232
Fax
(505) 984-1603
NPI assigned
Apr 18, 2019
Last updated
Apr 23, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2019

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

Authorized official

Name
Hope Wade
Title
Coo
Phone
(928) 607-0495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

433 Saint Michaels Dr
Santa Fe, NM 87505-7601

Mailing address

455 Saint Michaels Dr
Santa Fe, NM 87505-7601

Other names 1

  • CHRISTUS St. Vincent Medical Specialty Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040105000372 NM Part B Supplier - Clinic/Group Practice 6608775135 Receives reassigned benefits from 425 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Santa Fe, NM; Los Alamos, NM; Albuquerque, NM; Espanola, NM; Farmington, NM; Las Vegas, NM

National Provider Directory

National Provider Directory
Tax ID family
Santa Fe Med Lab28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

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

View all 27

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555977600000",
    "number": "1770146391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SAINT MICHAELS DR",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875057601",
            "telephone_number": "505-988-1232",
            "fax_number": "505-984-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENT HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-18",
        "last_updated": "2019-04-23",
        "status": "A",
        "authorized_official_last_name": "WADE",
        "authorized_official_first_name": "HOPE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "928-607-0495"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS St. Vincent Medical Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRISTUS St. Vincent Medical Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2019; 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.