Fiesta Park Healthcare LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

FIESTA PARK HEALTHCARE LLC

Doing business as

The Medical Resort at Fiesta Park

Practice address

8820 Horizon Blvd NE
Albuquerque, NM 87113-1689

Phone

(505) 998-1551

NPI assigned

Oct 11, 2011

Last updated

Dec 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Jeremy Martin

Title

Ceo

Phone

(505) 652-1985

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Medical Resort at Fiesta Park Doing business as

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418169600000",
    "number": "1962787812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8820 HORIZON BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131689",
            "telephone_number": "505-998-1551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 HORIZON BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131689",
            "telephone_number": "505-998-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIESTA PARK HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-11",
        "last_updated": "2014-12-10",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JEREMY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-652-1985",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "17631823",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medical Resort at Fiesta Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brenda C Fierro-Simeone
• Alejandro Fierro, MD
• Beatrice Fierro
• John Fierro
• Kim J. Fierro, M.S., CCC-SLP
• Fiesta Park Wellness & Rehabilitation LLC
• Fifty N Fit Inc
• Gregory James Figiel, PT, DPT, COS-C
• Loriel Figiel, RN
• Casey L Figueredo

• Skilled Nursing Facility in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Skilled Nursing Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.