NPIMap

Organization Active NPI

Las Cruces Physician Practices LLC

Doing business as MMC Physician Assistants

  • Surgical Physician Assistant
  • Las Cruces, NM
National Provider Identifier
1851574248
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
LAS CRUCES PHYSICIAN PRACTICES LLC
Doing business as
MMC Physician Assistants
Practice address
2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone
(505) 521-5277
NPI assigned
Dec 10, 2007
Last updated
Jun 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Authorized official

Name
Angie Mangum
Title
Director Physician Services
Phone
(505) 521-5277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X Primary

Addresses

Primary practice location

2450 S Telshor Blvd
Las Cruces, NM 88011-5069

Mailing address

PO Box 6310
Las Cruces, NM 88006-6310

Other names 1

  • MMC Physician Assistants Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Las Cruces Physician Practices LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1851574248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6310",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880066310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "505-521-5277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS CRUCES PHYSICIAN PRACTICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "DIRECTOR PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "505-521-5277"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MMC Physician Assistants",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.