NPIMap

Organization Active NPI

State of New Mexico

  • Rehabilitation Hospital
  • Roswell, NM
National Provider Identifier
1922094770
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
6026 Issued in NM
Legal business name
STATE OF NEW MEXICO
Practice address
72 Gail Harris Ave
Roswell, NM 88203-8116
Phone
(575) 347-3400
Fax
(575) 347-5177
NPI assigned
Sep 26, 2005
Organization subpart
Yes
Parent organization
NEW MEXICO REHABILITATION CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Authorized official

Name
Ms. Janie Davies
Title
Hospital Administrator
Phone
(575) 347-3400

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 6026 NM
Substance Use Disorder Rehabilitation Hospital Unit 276400000X 6026 NM
Rehabilitation Hospital 283X00000X 6026 NM Primary
Special Hospital 284300000X 6026 NM

Addresses

Primary practice location

72 Gail Harris Ave
Roswell, NM 88203-8116

Mailing address

72 Gail Harris Ave
Roswell, NM 88203-8116
Phone (575) 347-3400

Other identifiers 3

IdentifierTypeStateIssuer
00049528MedicaidNM
28858735MedicaidNM
00000273MedicaidNM

Other names 1

  • NEW MEXICO REHABILITATION CENTER Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100812000155 NM Part A Provider - Hospital 1052210689 Practice locations: Roswell, NM
O20110118000115 NM Part B Supplier - Clinic/Group Practice 1052210689 Receives reassigned benefits from 6 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Roswell, NM; Truth Or Consequence, NM; Santa Clara, NM; Las Vegas, NM

Hospital certification: CCN 323026

Legal name
STATE OF NEW MEXICO
Doing business as
NEW MEXICO REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Hospital – Rehabilitation
Participating since
Jul 1, 1985
Last certification
Oct 19, 2023
Beds
43
Ownership / control type
State
Organization structure
GovernmentProprietary
Enrollment address
72 Gail Harris St
New Mexico Rehabilitation Center
Roswell, NM 88203-8116
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 3

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
New Mexico Rehabilitation CenterCCN 323026
Ownership
Government
Certified
Jul 1, 1985
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Scientific Laboratory Division Nmdoh43 organizations share this tax ID, including this one
Part of
Scientific Laboratory Division Nmdoh

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Ownership & related parties

All disclosed owners & managing parties 2

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

NameRoleSinceShare
Jeff William Lamure Individual 5% Or Greater Direct Ownership Interest Nov 14, 2023
W-2 Managing EmployeeAd; Nov 14, 2023
Monica Garcia Individual Corporate DirectorChief Finance Director Jan 1, 2021

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
New Mexico State Veteran'S HomeTruth Or Consequences, NM, CCN 325092 Skilled nursing facility Operational/Managerial Control
Trustee of the SNF
Adp of the SNF		 Nov 1, 2024
Nov 1, 2024
Sep 17, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • State of New Mexico
    • Assisted Living Facility
    • Truth Or Consequences, NM
    • NPI 1942287370

    Adp of the SNF, Operational/Managerial Control, Trustee of the SNF

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737417600000",
    "number": "1922094770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 GAIL HARRIS AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882038116",
            "telephone_number": "575-347-3400",
            "fax_number": "575-347-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 GAIL HARRIS AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882038116",
            "telephone_number": "575-347-3400",
            "fax_number": "575-347-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW MEXICO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW MEXICO REHABILITATION CENTER",
        "enumeration_date": "2005-09-26",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A",
        "authorized_official_last_name": "DAVIES",
        "authorized_official_first_name": "JANIE",
        "authorized_official_title_or_position": "HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "575-347-3400",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NM",
            "license": "6026",
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NM",
            "license": "6026",
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "NM",
            "license": "6026",
            "primary": true
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "NM",
            "license": "6026",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00049528",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28858735",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000273",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW MEXICO REHABILITATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.