Individual provider Active NPI

Allen Edward Plymale, PHC

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Deming, NM
National Provider Identifier
1801919774
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PC00000048 Issued in NM
Practice address
122 S Gold Ave Ste 3
Deming, NM 88030-3755
Phone
(575) 544-7280
Fax
(575) 544-7281
NPI assigned
Apr 7, 2007
Last updated
May 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PC 48 NM
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PC00000048 NM Primary

Addresses

Primary practice location

122 S Gold Ave Ste 3
Deming, NM 88030-3755

Mailing address

1415 S Copper
Deming, NM 88030-5010
Phone (575) 544-7507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PC 48NMMDPharmacist
PC00000048NMMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mimbres Internal Medicine PA CurrentSince May 14, 2023 Accepting new patients
Donald J Stinar MD PastSince May 14, 2023 Accepting new patients

Locations

122 S Gold Ave
Ste 3
Deming, NM 88030
Phone (505) 544-7280

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1801919774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 S COPPER",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880305010",
            "telephone_number": "575-544-7507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S GOLD AVE STE 3",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880303755",
            "telephone_number": "575-544-7280",
            "fax_number": "575-544-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLYMALE",
        "first_name": "ALLEN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NM",
            "license": "PC 48",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "NM",
            "license": "PC00000048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deming, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; 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.