NPIMap

Organization Active NPI

Rocky Mountain Clinics, LLC

  • Addiction Medicine (Family Medicine) Physician
  • Albuquerque, NM
National Provider Identifier
1932958501
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
ROCKY MOUNTAIN CLINICS, LLC
Practice address
717 Encino PL NE Ste 12
Albuquerque, NM 87102-2638
Phone
(970) 493-9193
NPI assigned
May 16, 2024
Last updated
May 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Authorized official

Name
Sabrina Gibson
Title
Cfo
Phone
(307) 277-1006

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Addiction Medicine (Family Medicine) Physician 207QA0401X Primary

Addresses

Primary practice location

717 Encino PL NE Ste 12
Albuquerque, NM 87102-2638

Mailing address

1120 E Elizabeth St Ste G2
Fort Collins, CO 80524-4044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230630001619 NM Part B Supplier - Clinic/Group Practice 5597136218 Receives reassigned benefits from 22 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Las Cruces, NM; Taos, NM; Espanola, NM; Farmington, NM; Albuquerque, NM

Other NPIs on the same Medicare enrollment 4

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2304904Rocky Mountain Clinics - Albuquerque717 Encino Place, NE, Suite 12, Albuquerque, NM 87102Certificate of waiverMay 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Rocky Mountain Clinics LLC43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

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

View all 42

Locations

1120 E Elizabeth St
Ste 2
Fort Collins, CO 80524

717 Encino Pl NE
Ste 12
Albuquerque, NM 87102
Phone (505) 242-5373

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1932958501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 E ELIZABETH ST STE G2",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 ENCINO PL NE STE 12",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022638",
            "telephone_number": "970-493-9193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN CLINICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "307-277-1006"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.