Active NPI
Medi-Connect
- Land Ambulance
- Rio Rancho, NM
National Provider Identifier
1902638893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- Legal business name
- MEDI-CONNECT
- Practice address
- 4140 Jackie Rd SE
Rio Rancho, NM 87124-6624 - Phone
- (505) 477-4714
- NPI assigned
- Aug 19, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Edward Lidale Jones
- Title
- President
- Phone
- (619) 254-0547
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Wound Care Registered Nurse | 163WW0000X | |||
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | |||
| Community/Behavioral Health Agency | 251S00000X | |||
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Ambulance | 341600000X | |||
| Land Ambulance | 3416L0300X | Primary | ||
| Non-emergency Medical Transport (VAN) | 343900000X |
Addresses
Primary practice location
4140 Jackie Rd SE
Rio Rancho, NM 87124-6624
Mailing address
4140 Jackie Rd SE
Rio Rancho, NM 87124-6624
Phone (505) 477-4714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241015000152 | NM | Part B Supplier - Ambulance Service Supplier | 2365974474 | Practice locations: Rio Rancho, NM |
National Provider Directory
National Provider DirectoryLocations
1558 Stephanie Rd SE
Ste 104
Rio Rancho, NM 87124
Phone (505) 477-4714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724025600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1763078400000",
"number": "1902638893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4140 JACKIE RD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871246624",
"telephone_number": "505-477-4714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4140 JACKIE RD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871246624",
"telephone_number": "505-477-4714"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDI-CONNECT",
"organizational_subpart": "NO",
"enumeration_date": "2024-08-19",
"last_updated": "2025-11-14",
"certification_date": "2025-11-14",
"status": "A",
"authorized_official_last_name": "JONES",
"authorized_official_first_name": "EDWARD",
"authorized_official_middle_name": "LIDALE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "619-254-0547"
},
"taxonomies": [
{
"code": "163WW0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Wound Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "207QG0300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": null,
"license": null,
"primary": false
},
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": null,
"license": null,
"primary": true
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Rio Rancho, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.