Organization Active NPI

Medi-Connect

  • Land Ambulance
  • Rio Rancho, NM
National Provider Identifier
1902638893
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
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

Updated by the provider on Nov 14, 2025

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)CodeLicenseStatePrimary
Wound Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WW0000X
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
O20241015000152 NM Part B Supplier - Ambulance Service Supplier 2365974474 Practice locations: Rio Rancho, NM

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.