NPIMap

Organization Active NPI

Mescalero Indian Hospital

  • Rural Acute Care Hospital
  • Mescalero, NM
National Provider Identifier
1891886065
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Acute Care HospitalTaxonomy code 282NR1301X
Legal business name
MESCALERO INDIAN HOSPITAL
Practice address
318 Abalone Loop
Mescalero, NM 88340-0210
Phone
(505) 464-4441
Fax
(505) 464-3877
NPI assigned
Sep 27, 2006
Last updated
Dec 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Authorized official

Name
Mrs. Dorlynn Louise Simmons
Title
Chief Executive Officer
Phone
(505) 464-4441

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X NM Primary

Addresses

Primary practice location

318 Abalone Loop
Mescalero, NM 88340-0210

Mailing address

PO Box 210
318 Abalone Loop
Mescalero, NM 88340-0210
Phone (505) 464-4441

Other identifiers 1

IdentifierTypeStateIssuer
H2347MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031218000996 TX Part B Supplier - Clinic/Group Practice 9436056181 Receives reassigned benefits from 20 practitioners
Practice locations: Mescalero, NM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1891886065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 210",
            "address_2": "318 ABALONE LOOP",
            "city": "MESCALERO",
            "state": "NM",
            "postal_code": "883400210",
            "telephone_number": "505-464-4441",
            "fax_number": "505-464-3877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 ABALONE LOOP",
            "city": "MESCALERO",
            "state": "NM",
            "postal_code": "883400210",
            "telephone_number": "505-464-4441",
            "fax_number": "505-464-3877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESCALERO INDIAN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DORLYNN",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "505-464-4441",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H2347",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mescalero, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; 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.