NPIMap

Organization Active NPI

Presbyterian Medical Services

Doing business as Project Shield

  • Developmentally Disabled Services Day Training Agency
  • Farmington, NM
National Provider Identifier
1972712875
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
CU00006339 Issued in NM
Legal business name
PRESBYTERIAN MEDICAL SERVICES
Doing business as
Project Shield
Practice address
608 Reilly Ave
Farmington, NM 87401-2634
Phone
(505) 325-8931
Fax
(505) 326-7283
NPI assigned
May 21, 2007
Last updated
Apr 7, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Authorized official

Name
Mr. Doug Smith
Title
Exec. VP
Phone
(505) 982-5565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X CU00006339 NM Primary

Addresses

Primary practice location

608 Reilly Ave
Farmington, NM 87401-2634

Mailing address

PO Box 2267
Santa Fe, NM 87504-2267
Phone (505) 820-3466

Other identifiers 1

IdentifierTypeStateIssuer
D0834MedicaidNM

Other names 1

  • Project Shield Doing business as

National Provider Directory

National Provider Directory
Tax ID family
PMS Dba Roundtree Childrens' Development Services70 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

2015 E 12th St
Farmington, NM 87401
Phone (505) 326-2695

608 Reilly Ave
Farmington, NM 87401
Phone (505) 327-0301

Practitioners & affiliated clinicians

Practitioners 6

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": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649289600000",
    "number": "1972712875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2267",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875042267",
            "telephone_number": "505-820-3466",
            "fax_number": "505-992-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 REILLY AVE",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874012634",
            "telephone_number": "505-325-8931",
            "fax_number": "505-326-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESBYTERIAN MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "EXEC. VP",
        "authorized_official_telephone_number": "505-982-5565",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NM",
            "license": "CU00006339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D0834",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Project Shield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Project Shield",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.