Atlas Integrated Health LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ATLAS INTEGRATED HEALTH LLC

Practice address

4740 N Butler Ave
Farmington, NM 87401-0826

Phone

(505) 325-2604

Fax

(505) 327-1976

NPI assigned

Apr 12, 2021

Last updated

Apr 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Erica Sussex-Grant, DC

Title

Registered Agent/Manager

Phone

(505) 325-2604

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1871173005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N BUTLER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010826",
            "telephone_number": "505-325-2604",
            "fax_number": "505-327-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 N BUTLER AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874010826",
            "telephone_number": "505-325-2604",
            "fax_number": "505-327-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLAS INTEGRATED HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-12",
        "last_updated": "2021-04-12",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "SUSSEX-GRANT",
        "authorized_official_first_name": "ERICA",
        "authorized_official_title_or_position": "REGISTERED AGENT/MANAGER",
        "authorized_official_telephone_number": "505-325-2604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Farmington, NM
• Providers in Farmington, NM by specialty
• Multi-Specialty Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.