NPIMap

Organization Active NPI

San Juan Regional Medical Center Inc

Doing business as SJHP Family Medicine Farmington

  • Family Medicine Physician
  • Farmington, NM
National Provider Identifier
1770189045
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SAN JUAN REGIONAL MEDICAL CENTER INC
Practice address
656 W Maple St
Farmington, NM 87401-5968
Phone
(505) 609-2990
Fax
(505) 609-2996
NPI assigned
Dec 10, 2020
Last updated
Dec 10, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
SAN JUAN REGIONAL MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Authorized official

Name
Kim R Hipsher-Byrd
Title
Cbo Director
Phone
(505) 609-2258

Specialties & licenses 1

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

Addresses

Primary practice location

656 W Maple St
Farmington, NM 87401-5968

Mailing address

PO Box 6210
Farmington, NM 87499-6210
Phone (505) 609-2258

Other names 1

  • SJHP FAMILY MEDICINE FARMINGTON Other name

National Provider Directory

National Provider Directory
Tax ID family
Sjrmc Emergency RM Phys13 organizations share this tax ID, including this one
Part of
Sjrmc Emergency RM Phys

Other organizations with this tax ID 12

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

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607558400000",
    "number": "1770189045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6210",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874996210",
            "telephone_number": "505-609-2258",
            "fax_number": "505-609-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015968",
            "telephone_number": "505-609-2990",
            "fax_number": "505-609-2996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAN JUAN REGIONAL MEDICAL CENTER INC",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "HIPSHER-BYRD",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CBO DIRECTOR",
        "authorized_official_telephone_number": "505-609-2258"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SJHP FAMILY MEDICINE FARMINGTON",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SJHP FAMILY MEDICINE FARMINGTON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.