Organization Active NPI

Native Resource Development Company Inc.

  • In Home Supportive Care Agency
  • Gallup, NM
National Provider Identifier
1992832455
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
24855731 Issued in NM
Legal business name
NATIVE RESOURCE DEVELOPMENT COMPANY INC.
Practice address
318 Dee Ann Ave
Gallup, NM 87301-5783
Phone
(505) 726-0201
Fax
(505) 726-0202
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Penny Emerson
Title
Owner
Phone
(505) 867-5372

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 24855731 NM Primary
In Home Supportive Care Agency 253Z00000X 777245 AZ
Non-emergency Medical Transport (VAN) 343900000X 30550297 NM
Non-emergency Medical Transport (VAN) 343900000X 073338 AZ

Addresses

Primary practice location

318 Dee Ann Ave
Gallup, NM 87301-5783

Mailing address

318 Dee Ann Ave
Gallup, NM 87301-5783
Phone (505) 726-0201

Other identifiers 5

IdentifierTypeStateIssuer
43979203MedicaidNM
24855731MedicaidNM
30550297MedicaidNM
073338MedicaidAZ
777245MedicaidAZ

Other names 1

  • Quality Home Care Other name

National Provider Directory

National Provider Directory

Locations

318 Dee Ann Ave
Gallup, NM 87301
Phone (505) 726-0201

324 Dee Ann Ave
Ste A
Gallup, NM 87301
Phone (505) 373-2636

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1992832455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 DEE ANN AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015783",
            "telephone_number": "505-726-0201",
            "fax_number": "505-726-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 DEE ANN AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015783",
            "telephone_number": "505-726-0201",
            "fax_number": "505-726-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIVE RESOURCE DEVELOPMENT COMPANY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "EMERSON",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-867-5372"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NM",
            "license": "24855731",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "AZ",
            "license": "777245",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NM",
            "license": "30550297",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AZ",
            "license": "073338",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43979203",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24855731",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30550297",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "073338",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "777245",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quality Home Care",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.