NPIMap

Organization Active NPI

Presbyterian Healthcare Services

  • General Practice Physician
  • Corona, NM
National Provider Identifier
1912324930
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
3156 Issued in NM
Legal business name
PRESBYTERIAN HEALTHCARE SERVICES
Practice address
471 Main St
Corona, NM 88318
Phone
(575) 849-1561
Fax
(575) 849-1562
NPI assigned
Mar 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Authorized official

Name
Bo Beames
Title
VP RDS
Phone
(575) 835-8700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 3156 NM Primary

Addresses

Primary practice location

471 Main St
Corona, NM 88318

Mailing address

PO Box 26666
Albuquerque, NM 87125-6666
Phone (505) 923-5356

Other identifiers 1

IdentifierTypeStateIssuer
07773242MedicaidNM

Other names 1

  • Corona Health Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Espanola Hospital Pharm69 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395878400000",
    "number": "1912324930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "471 MAIN ST",
            "city": "CORONA",
            "state": "NM",
            "postal_code": "88318",
            "telephone_number": "575-849-1561",
            "fax_number": "575-849-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-27",
        "last_updated": "2014-03-27",
        "status": "A",
        "authorized_official_last_name": "BEAMES",
        "authorized_official_first_name": "BO",
        "authorized_official_title_or_position": "VP RDS",
        "authorized_official_telephone_number": "575-835-8700"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NM",
            "license": "3156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07773242",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.