NPIMap

Organization Active NPI

Memorial Medical Cener

  • Family Medicine Physician
  • Las Cruces, NM
National Provider Identifier
1932583820
Registry record updated Jul 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
RS2015-0499 Issued in NJ
Legal business name
MEMORIAL MEDICAL CENER
Practice address
2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone
(575) 521-5385
NPI assigned
Jul 10, 2015
Last updated
Jul 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2015

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

Authorized official

Name
Donna Madrid
Title
Asst. Program Coord
Phone
(575) 571-2214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RS2015-0499 NJ Primary

Addresses

Primary practice location

2450 S Telshor Blvd
Las Cruces, NM 88011-5069

Mailing address

2450 S Telshor Blvd
Las Cruces, NM 88011-5069
Phone (575) 521-5385

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1436486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436486400000",
    "number": "1932583820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "575-521-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 S TELSHOR BLVD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880115069",
            "telephone_number": "575-521-5385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL MEDICAL CENER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-10",
        "last_updated": "2015-07-10",
        "status": "A",
        "authorized_official_last_name": "MADRID",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "ASST. PROGRAM COORD",
        "authorized_official_telephone_number": "575-571-2214"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "RS2015-0499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2015; 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.