Pueblo of Laguna

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

54194 Issued in NM

Legal business name

PUEBLO OF LAGUNA

Doing business as

Laguna Fire& Rescue

Practice address

5 Blue Star Loop
Paraje, NM 87007

Phone

(505) 552-1102

Fax

(505) 552-6577

NPI assigned

Dec 6, 2006

Last updated

Oct 22, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Miles King

Title

Chief Financial Officer

Phone

(505) 552-5779

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Laguna Fire& Rescue Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Tax ID family

Pueblo of Laguna2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Pueblo of Laguna

  • Community/Behavioral Health Agency
  • Laguna, NM
  • NPI 1881011484
  NPD tax ID

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Laguna Rainbow Corporation

  dba Laguna Rainbow Nursing Center

  • Skilled Nursing Facility
  • Casa Blanca, NM
  • NPI 1316926041

  Member Of

  NPD member

All facility ownership & control disclosures 1

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

Owned or controlled facilities with NPI records 1

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

• Laguna Rainbow Corporation

  dba Laguna Rainbow Nursing Center

  • Skilled Nursing Facility
  • Casa Blanca, NM
  • NPI 1316926041

  5% Or Greater Direct Ownership Interest

  CMS ownership

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256169600000",
    "number": "1932267259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "LAGUNA",
            "state": "NM",
            "postal_code": "870260179",
            "telephone_number": "505-552-5796",
            "fax_number": "505-552-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BLUE STAR LOOP",
            "city": "PARAJE",
            "state": "NM",
            "postal_code": "87007",
            "telephone_number": "505-552-1102",
            "fax_number": "505-552-6577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO OF LAGUNA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2009-10-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "MILES",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "505-552-5779",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NM",
            "license": "54194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH PLAN",
            "identifier": "201078520",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NM",
            "identifier": "00NM00RC01",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "R0225",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOVELACE SALUD",
            "identifier": "10014280",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "964678",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laguna Fire& Rescue",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laguna Healthcare Corporation (Laguna Community Health Center Pharmacy)
• Laguna Healthcare Corporation (Laguna Community Health Center)
• Mariana Mejia Botero, M.D.
• Nicolas Milligan, M.D.
• Lori Ann Ortiz, MPT
• Marian Ramsey-Ford, NP-C

• Land Ambulance in Paraje, NM
• Providers in Paraje, NM by specialty
• Land Ambulance in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.