NPIMap

Organization Active NPI

Placitas Mountain Medical, Inc

  • Urgent Care Clinic/Center
  • Edgewood, NM
National Provider Identifier
1902333776
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PLACITAS MOUNTAIN MEDICAL, INC
Practice address
104 Quail TRL Unit B
Edgewood, NM 87015-7185
Phone
(505) 309-0455
NPI assigned
May 11, 2017
Last updated
May 11, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
PLACITAS MOUNTAIN MEDICAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Authorized official

Name
James Marc Beverly
Title
Owner
Phone
(505) 281-5180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

104 Quail TRL Unit B
Edgewood, NM 87015-7185

Mailing address

12127B Hwy 14 N Ste 5
Cedar Crest, NM 87008-9499
Phone (505) 281-5180

National Provider Directory

National Provider Directory
Part of
Placitas MTN Med Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1902333776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12127B HWY 14 N STE 5",
            "city": "CEDAR CREST",
            "state": "NM",
            "postal_code": "870089499",
            "telephone_number": "505-281-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 QUAIL TRL UNIT B",
            "city": "EDGEWOOD",
            "state": "NM",
            "postal_code": "870157185",
            "telephone_number": "505-309-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACITAS MOUNTAIN MEDICAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PLACITAS MOUNTAIN MEDICAL, INC.",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "BEVERLY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-281-5180"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.