Country Medical Services, LLC

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

License

R24775 Issued in NM

Legal business name

COUNTRY MEDICAL SERVICES, LLC

Practice address

NM State Highway 120, #1252 (Fyi Rural Address)
Pob 203
Ocate, NM 87734-0203

Phone

(575) 666-2475

NPI assigned

Nov 21, 2008

Last updated

Oct 22, 2011By 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

Ms. Diana Louise Lewis, NP-C

Title

Owner of Business/ NP-C Provider

Phone

(575) 666-2475

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319241600000",
    "number": "1972758688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "# 1252, NM STATE HIGHWAY 120 (FYI RURAL ADDRESS)",
            "address_2": "POB 203",
            "city": "OCATE",
            "state": "NM",
            "postal_code": "877340203",
            "telephone_number": "575-666-2475",
            "fax_number": "800-560-1129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NM STATE HIGHWAY 120, #1252 (FYI RURAL ADDRESS)",
            "address_2": "POB 203",
            "city": "OCATE",
            "state": "NM",
            "postal_code": "877340203",
            "telephone_number": "575-666-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY MEDICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-21",
        "last_updated": "2011-10-22",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER OF BUSINESS/ NP-C PROVIDER",
        "authorized_official_telephone_number": "575-666-2475",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "NM",
            "license": "R24775",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22002570",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Louise Lewis, N.P.

• Family Health Clinical Nurse Specialist in Ocate, NM
• Providers in Ocate, NM by specialty
• Family Health Clinical Nurse Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; 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.