NPIMap

Organization Active NPI

Laguna Healthcare Corporation

Doing business as Laguna Community Health Center

  • Family Medicine Physician
  • Paraje, NM
National Provider Identifier
1962001024
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LAGUNA HEALTHCARE CORPORATION
Doing business as
Laguna Community Health Center
Practice address
6 Basswood Rd
Paraje, NM 87007
Phone
(505) 552-5664
NPI assigned
Oct 20, 2020
Last updated
Jan 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Authorized official

Name
Carrie L Sarnicky
Title
Ceo
Phone
(505) 552-5664

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy 332800000X

Addresses

Primary practice location

6 Basswood Rd
Paraje, NM 87007

Mailing address

PO Box 1407
Laguna, NM 87026-1407
Phone (505) 552-5664

Other names 1

  • Laguna Community Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210119000388 TX Part B Supplier - Clinic/Group Practice 2365855079 Receives reassigned benefits from 23 practitioners
Practice locations: Paraje, NM

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 93

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.

View all 93

NPI Registry JSON

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

{
    "created_epoch": "1603152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1962001024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1407",
            "city": "LAGUNA",
            "state": "NM",
            "postal_code": "870261407",
            "telephone_number": "505-552-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BASSWOOD RD",
            "city": "PARAJE",
            "state": "NM",
            "postal_code": "87007",
            "telephone_number": "505-552-5664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGUNA HEALTHCARE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-20",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "SARNICKY",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-552-5664"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332800000X",
            "taxonomy_group": "",
            "desc": "Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laguna Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Laguna Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paraje, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.