SAN JUAN REGIONAL MEDICAL CENTER INC (NPI# 1033327770) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033327770 |
| Entity Type | Organization |
| Organization Name | SAN JUAN REGIONAL MEDICAL CENTER INC |
| Other Organization Name | SAN JUAN REGIONAL HEART CENTER |
| Practice Address |
407 S Schwartz Ave Suite 202 Farmington NM 87401 |
| Mailing Address |
Po Box 6210 Farmington NM 87499-6210 |
| Practice Telephone | 5056096770 |
| Practice Fax Number | 5056096775 |
| Mailing Telephone | 5056092258 |
| Mailing Fax Number | 5056092259 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2018-07-30 |
| Authorized Official Name | KAREN MILLER (CFO) |
| Authorized Official Telephone | 5056092000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 208800000X | Urology | Allopathic & Osteopathic Physicians | ||
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 97172766 | 05 | |
| CO | 39608514 | 05 |
| Other Name | Type Code |
|---|---|
| SAN JUAN REGIONAL CARDIOLOGY | Doing Business As Name - Organization |
| San Juan Regional Heart Center | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 480 Wolverine Dr Ste 12, Bayfield, CO 811229653 | 9704440260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902463508 | San Juan Regional Medical Center Inc | Urology | 1485 Florida Rd Ste 103a, Durango, CO 81301-6873 | 2019-05-20 |
| 1174820153 | San Juan Regional Medical Center Inc | Emergency Medicine | 4251 English Rd, Farmington, NM 87402-1116 | 2011-02-28 |
| 1811915234 | San Juan Regional Medical Center Inc | Physical Medicine & Rehabilitation | 525 S Schwartz Ave, Farmington, NM 87401-5955 | 2006-07-17 |
| 1225076003 | San Juan Regional Medical Center Inc | Internal Medicine | 407 S. Schwartz Ave, Suite 201, Farmington, NM 87401-5973 | 2006-06-03 |
| 1861467433 | San Juan Regional Medical Center Inc | Internal Medicine | 120 Llano St, Aztec, NM 87410 | 2006-02-17 |
| 1326663592 | San Juan Regional Medical Center Inc | Rehabilitation Unit | 525 S Schwartz Ave, Farmington, NM 87401-5955 | 2020-06-12 |
| 1639662901 | San Juan Regional Medical Center Inc | Internal Medicine | 940 W Pinon St, Farmington, NM 87401-5905 | 2018-06-12 |
| 1508219916 | San Juan Regional Medical Center Inc | Family Medicine | 100 N Church St Ste C, Bloomfield, NM 87413-5754 | 2016-07-20 |
| 1003296534 | San Juan Regional Medical Center Inc | Urology | 2700 Farmington Ave, Building E, Suite 1, Farmington, NM 87401-4559 | 2015-05-29 |
| 1023379609 | San Juan Regional Medical Center Inc | Specialist/Technologist, Other | 801 W Maple St, Farmington, NM 87401-5630 | 2012-05-31 |
| Street Address |
407 S SCHWARTZ AVE SUITE 202 |
| City | FARMINGTON |
| State | NM |
| Zip Code | 87401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376542118 | Christopher Lesueur | Internal Medicine | 407 S Schwartz Ave, Ste 201, Farmington, NM 87401-5925 | 2005-07-14 |
| 1669921003 | Laprincess D Tso | Nurse Practitioner | 407 S Schwartz Ave, Suite 101, Farmington, NM 87401-5925 | 2016-09-27 |
| 1275981557 | Jessica A Conklin | Nurse Practitioner | 407 S Schwartz Ave, Suite 102, Farmington, NM 87401-5925 | 2016-05-27 |
| 1962878157 | Martha Jean Luhrs | Nurse Practitioner | 407 S Schwartz Ave, Suite 202, Farmington, NM 87401-5925 | 2015-08-11 |
| 1043693948 | Molly Patricia Hummel | Physician Assistant | 407 S Schwartz Ave, Suite 101, Farmington, NM 87401-5925 | 2015-07-09 |
| 1790195725 | Pierre Mckenzie | Nurse Practitioner | 407 S Schwartz Ave, Suite 202, Farmington, NM 87401-5925 | 2014-04-29 |
| 1811327901 | Katherine Rebecca Mccrea Jarvis | Registered Nurse | 407 S Schwartz Ave, Suite 102, Farmington, NM 87401-5925 | 2013-11-26 |
| 1205185261 | Mary Pickard | Physician Assistant | 407 S Schwartz Ave, Suite 202, Farmington, NM 87401-5925 | 2012-09-06 |
| 1013286269 | Jennifer Lizabeth Manganello | Nurse Practitioner | 407 S Schwartz Ave, Suite 101, Farmington, NM 87401 | 2011-12-16 |
| 1356625917 | Tracie D Grace | Nurse Practitioner | 407 S Schwartz Ave, Suite 201, Farmington, NM 87401-5925 | 2011-09-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035192 | Jaylene Miller | Behavior Technician | 912 Fairgrounds Rd. Trl 36, Farmington, NM 87401 | 2020-08-28 |
| 1255940326 | John Andrew Martinez | Behavioral Analyst | 211 N Auburn, Farmington, NM 87401 | 2020-07-24 |
| 1598304990 | Chasitity Beulah Nez | Behavior Technician | 37 Rd 7101 #127, Farmington, NM 87401 | 2020-01-02 |
| 1205478575 | Micah Magee | Speech-Language Pathologist | Farmington High School, 2200 N. Sunset Ave, Farmington, NM 87401 | 2019-10-08 |
| 1831659754 | Lelilah Todacheene | Social Worker | 1204 Camina Real, Farmington, NM 87401 | 2019-03-25 |
| 1306323555 | Litany of Life | Counselor | 1010 Ridgeway Place, Farmington, NM 87401 | 2018-07-20 |
| 1093291213 | Brittany Bigham | Nurse Practitioner | 1001 W Broadway Ste E, Farmington, NM 87401 | 2018-07-11 |
| 1528556305 | Hairoun Home Health | Home Health | 1200 East 20th Street, Farmington, NM 87401 | 2018-04-26 |
| 1003338732 | Silver Tongue Speech & Voice, LLC | Clinic/Center | 3001 Northridge Dr Ste C, Farmington, NM 87401 | 2017-07-14 |
| 1902256621 | Capacity Builders Inc | Taxi | 418 W Broadway, Farmington, NM 87401 | 2016-06-14 |
| Find all providers in zip 87401 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881863009 | The Heart Health Center, PC | Internal Medicine | 620 Maple Valley Dr, Farmington, MO 63640-1976 | 2008-02-21 |
| 1598942468 | Alix Junior Tercius | Internal Medicine | University of Connecticut Health Center, 260 Farmington Ave, Farmington, CT 06032 | 2008-01-23 |
| 1477643179 | Utah Cardiology PC | Internal Medicine | 444 W Bourne Circle, Suite 200, Farmington, UT 84025 | 2006-10-13 |
| 1225023328 | Scott H West | Internal Medicine | 444 W Bourne Cir Ste 200, Farmington, UT 84025 | 2005-09-14 |
| 1952786055 | Hhc Health Care, LLC | Internal Medicine | 1151 Hazel Lane, Farmington, MO 63640 | 2015-07-30 |
| 1639515869 | Daniel Taylor Fronk | Internal Medicine | 444 W Bourne Cir Ste 200, Farmington, UT 84025-3657 | 2013-05-15 |
| 1053602672 | Mariam Shakir Azeem | Internal Medicine | 263 Farmington Ave, Farmington, CT 06032-1956 | 2011-04-30 |
| 1457650442 | Christopher Y Kim | Internal Medicine | 444 W Bourne Cir Ste 200, Farmington, UT 84025 | 2011-03-16 |
| 1427216860 | Juyong Lee | Internal Medicine | 263 Farmington Ave, Farmington, CT 06030-4038 | 2008-05-31 |
| 1417128372 | Cardiology Diagnostics, Ltd. | Internal Medicine | 1101 Weber Rd, Suite 105, Farmington, MO 63640-3326 | 2008-03-19 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 87401 |
Please comment or provide details below to improve the information on SAN JUAN REGIONAL MEDICAL CENTER INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.