NPIMap

Organization Active NPI

State of New Mexico

Doing business as New Mexico State Veterans Home

  • Assisted Living Facility
  • Truth Or Consequences, NM
National Provider Identifier
1942287370
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
5087 Issued in NM
Legal business name
STATE OF NEW MEXICO
Doing business as
New Mexico State Veterans Home
Practice address
992 S Broadway
Truth Or Consequences, NM 87901-3198
Phone
(575) 894-4200
Fax
(575) 894-4291
NPI assigned
Dec 28, 2005
Last updated
Feb 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
STATE OF NEW MEXICOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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

Authorized official

Name
Kenneth Shull
Title
Hospital Administrator
Phone
(575) 894-4216

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 5087 NM Primary
Skilled Nursing Facility 314000000X 5363 NM

Addresses

Primary practice location

992 S Broadway
Truth Or Consequences, NM 87901-3198

Mailing address

992 S Broadway
Truth Or Consequences, NM 87901-3198
Phone (575) 894-4200

Other identifiers 1

IdentifierTypeStateIssuer
I0480MedicaidNM

Other names 1

  • New Mexico State Veterans Home Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040102000676 TX Part A Provider - Skilled Nursing Facility 1052210689 Practice locations: Truth Or Consequences, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1942287370. Details of each certification follow.

Skilled nursing facility certification: CCN 325092

Legal name
STATE OF NEW MEXICO
Doing business as
NEW MEXICO STATE VETERAN'S HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 25, 1994
Last certification
Dec 27, 2024
Beds
131
Ownership / control type
State
Organization structure
GovernmentNon-profit
Enrollment address
992 S Broadway
Truth Or Consequences, NM 87901-3198
Nursing home name
NEW MEXICO STATE VETERANS HOME

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
New Mexico State Veterans HomeCCN 325092 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Jan 25, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
131125.9 residents per day on average
Penalties (3 years)
1Fines totaling $44,226

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Department of Health Public Health Division43 organizations share this tax ID, including this one
Part of
Department of Health Public Health Division

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 3

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

NameRoleSinceShare
Kenneth a Shull Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jul 23, 2025
Brent Hatley Individual Operational/Managerial Control Jan 1, 2025
State of New Mexico Organization, Truth Or Consequences, NM Medical provider/supplier Operational/Managerial Control Nov 1, 2024
Trustee of the SNF Nov 1, 2024
Adp of the SNF Sep 17, 2025

Owners & managing parties with NPI records 4

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • New Mexico Department of Health

    dba Department of Health Immunization

    • Public Health or Welfare Agency
    • Santa Fe, NM
    • NPI 1578609459

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

    CMS ownership
  • State of New Mexico

    dba New Mexico State Veterans Home Physicians

    • Skilled Nursing Facility
    • Truth Or Consequences, NM
    • NPI 1578730230

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

    CMS ownership
  • State of New Mexico

    dba New Mexico Rehabilitation Center

    • Rehabilitation Hospital
    • Roswell, NM
    • NPI 1922094770

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

    CMS ownership
  • State of New Mexico

    dba Fort Bayard Medical Center

    • Long Term Care Hospital
    • Santa Clara, NM
    • NPI 1982730669

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

    CMS ownership

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.

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": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740355200000",
    "number": "1942287370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992 S BROADWAY",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879013198",
            "telephone_number": "575-894-4200",
            "fax_number": "575-894-4291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 S BROADWAY",
            "city": "TRUTH OR CONSEQUENCES",
            "state": "NM",
            "postal_code": "879013198",
            "telephone_number": "575-894-4200",
            "fax_number": "575-894-4291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW MEXICO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATE OF NEW MEXICO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A",
        "authorized_official_last_name": "SHULL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "HOSPITAL ADMINISTRATOR",
        "authorized_official_telephone_number": "575-894-4216"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NM",
            "license": "5087",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NM",
            "license": "5363",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "I0480",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Mexico State Veterans Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Truth Or Consequences, NM

Sources for this page

Verify at the official NPI Registry.