Sierra Blanca Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2000-25 Issued in NM

Legal business name

SIERRA BLANCA FAMILY MEDICINE PC

Practice address

208 Porr Dr
Ruidoso, NM 88345-6713

Phone

(575) 630-1214

Fax

(575) 630-2083

NPI assigned

Sep 27, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Frank J Dimotta, MD

Title

Provider Owner

Phone

(575) 630-1214

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1992132500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 PORR DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456713",
            "telephone_number": "575-630-1214",
            "fax_number": "575-630-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PORR DR",
            "city": "RUIDOSO",
            "state": "NM",
            "postal_code": "883456713",
            "telephone_number": "575-630-1214",
            "fax_number": "575-630-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA BLANCA FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-27",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "DIMOTTA",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROVIDER OWNER",
        "authorized_official_telephone_number": "575-630-1214",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "2000-25",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72884",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard L. Scott, BMS
• Walter R Seidel, MD
• Kelli D Shaw, LADAC
• Shuttle Ruidoso, LLC
• Sierra Blanca Counseling
• Sierra Blanca Pharmacy LLC
• Anjanette T Silva, M.A., CCC-SLP
• Abhinav Singh, MD
• Smarthealth Enterprise LLC
• Dennis Smith

• Family Medicine Physician in Ruidoso, NM
• Providers in Ruidoso, NM by specialty
• Family Medicine Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.