NPIMap

Organization Active NPI

Ben Archer Health Center

  • Federally Qualified Health Center (FQHC)
  • Alamogordo, NM
National Provider Identifier
1902831977
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
321880 Issued in NM
Legal business name
BEN ARCHER HEALTH CENTER
Practice address
2150 Highway 54 S
Alamogordo, NM 88310-7330
Phone
(575) 443-8133
Fax
(575) 443-8055
NPI assigned
Jul 11, 2006
Last updated
Sep 29, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Authorized official

Name
Mary Alice Garay
Title
Executive Director
Phone
(575) 267-3280

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 3015 NM
Federally Qualified Health Center (FQHC) 261QF0400X 321880 NM Primary

Addresses

Primary practice location

2150 Highway 54 S
Alamogordo, NM 88310-7330

Mailing address

PO Box 370
Hatch, NM 87937-0370
Phone (575) 267-3280

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031120000966 NM Part B Supplier - Clinic/Group Practice 7517878796 Receives reassigned benefits from 92 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Truth Or Consequences, NM; Radium Springs, NM; Deming, NM; Las Cruces, NM; Columbus, NM; Hatch, NM; Alamogordo, NM
O20050526001068 NM Part A Provider - Federally Qualified Health Center (FQHC) 7517878796 Practice locations: Alamogordo, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902831977. Details of each certification follow.

Federally qualified health center certification: CCN 321880

Legal name
BEN ARCHER HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 5, 2000
Last certification
Sep 5, 2000
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Mar 27, 1973 in NM
Enrollment address
2150 Highway 54 S
Alamogordo, NM 88310-7330
Related CCNs
321805

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2150 Highway 54 S
Alamogordo, NM 88310
Phone (575) 443-8133

1600 Thorpe Rd
Las Cruces, NM 88012
Phone (505) 267-3088

1990 Bruins Ln
Las Cruces, NM 88007
Phone (575) 523-2772

3331 Del Rey Blvd
Las Cruces, NM 88012
Phone (575) 267-3280

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Christina Fierro Individual Corporate Director Jan 1, 2007
Vicente Zamora Individual Corporate Director Feb 1, 2021
Mary Alice Garay Individual 5% Or Greater Direct Ownership Interest Jun 1, 1993
Corporate Director Jun 1, 1993
W-2 Managing Employee Jun 1, 1993
Sylvia McGuire Individual Corporate Director Sep 1, 2012
Shawna Runyan Individual Corporate Director Feb 1, 2021
Bobby Cordero Individual Corporate Director Feb 1, 2021
Patricia Leyba Individual Corporate Director Apr 1, 2001
Elwin Roach Individual Corporate Director Jan 1, 2002
Ryan Jaramillo Individual Corporate Director Feb 1, 2021

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1902831977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "HATCH",
            "state": "NM",
            "postal_code": "879370370",
            "telephone_number": "575-267-3280",
            "fax_number": "575-267-1747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 HIGHWAY 54 S",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883107330",
            "telephone_number": "575-443-8133",
            "fax_number": "575-443-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEN ARCHER HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "GARAY",
        "authorized_official_first_name": "MARY ALICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "575-267-3280"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NM",
            "license": "3015",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NM",
            "license": "321880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamogordo, NM

Sources for this page

Verify at the official NPI Registry.