NPIMap

Organization Active NPI

Brazos Valley Cardio Respiratory

  • Oxygen Equipment & Supplies (DME)
  • Ruidoso, NM
National Provider Identifier
1952585184
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
0059159 Issued in TX
Legal business name
BRAZOS VALLEY CARDIO RESPIRATORY
Practice address
141-A Mescalero TR.
Ruidoso, NM 88345
Phone
(575) 257-5083
Fax
(575) 257-5083
NPI assigned
Dec 24, 2007
Last updated
Apr 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Authorized official

Name
Mr. Kevin E Miller, RRT/RCPNPI 1306844915
Title
Owner
Phone
(575) 257-5083

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X 56124 TX
Oxygen Equipment & Supplies (DME) 332BX2000X 0059159 TX Primary

Addresses

Primary practice location

141-A Mescalero TR.
Ruidoso, NM 88345

Mailing address

141-A Mescalero TR.
Ruidoso, NM 88345
Phone (575) 257-5083

Other identifiers 1

IdentifierTypeStateIssuer
0111049-01MedicaidTX

National Provider Directory

National Provider Directory

Locations

141 Mescalero Trl
#A
Ruidoso, NM 88345
Phone (575) 257-5083

Practitioners & affiliated clinicians

Practitioners 1

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": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1952585184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141-A MESCALERO TR.",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "88345",
            "telephone_number": "575-257-5083",
            "fax_number": "575-257-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141-A MESCALERO TR.",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "88345",
            "telephone_number": "575-257-5083",
            "fax_number": "575-257-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS VALLEY CARDIO RESPIRATORY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-257-5083",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT/RCP"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "TX",
            "license": "56124",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TX",
            "license": "0059159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0111049-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruidoso, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.