SOUTHWEST MEDICAL CLINIC INC (NPI# 1144468075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144468075 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST MEDICAL CLINIC INC |
| Practice Address |
2230 Bosque Farms Blvd Bosque Farms NM 87068-9334 |
| Practice Telephone | 5058690300 |
| Mailing Telephone | 5059757269 |
| Enumeration Date | 2009-01-30 |
| Last Update Date | 2009-05-26 |
| Authorized Official Name | MRS. FATEMEH MANSOORI (OWNER/ PROVIDER) |
| Authorized Official Telephone | 5058690300 |
| Authorized Official Credential | FNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R37006 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 25079310 | 05 | |
| NM | MEDICARE | 349531402 | 01 |
| Street Address |
2230 BOSQUE FARMS BLVD |
| City | BOSQUE FARMS |
| State | NM |
| Zip Code | 87068-9334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346335759 | Fatemeh Mansoori | Family Medicine | 2230 Bosque Farms Blvd, Bosque Farms, NM 87068-9334 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508313040 | Tanya Gonzales | Registered Nurse | 1575 West Bosque Looop, Bosque Farms, NM 87068 | 2016-09-01 |
| 1295025757 | Michelle Mari Nelson | Social Worker | 2720 Parklane Dr, Bosque Farms, NM 87068 | 2011-04-18 |
| 1437570215 | Jacqueline Kelly-romero | Registered Nurse | 1390 W. Bosque Lp, Bosque Farms, NM 87068-1300 | 2013-12-23 |
| 1518417393 | Ashley Elizabeth Abeita | Technician, Other | 22 Tr 22 # A, Bosque Farms, NM 87068-8123 | 2016-10-05 |
| 1487927489 | Health Quest Wellness Bosque, LLC | Chiropractor | 155 Bosque Farms Blvd, Bosque Farms, NM 87068-8931 | 2012-02-22 |
| 1104156793 | Roberta Hartman | Specialist | 635 Bosque Farms Blvd # 87068, 1030 Stovall Ave Bosque Farms Nm, Bosque Farms, NM 87068-8933 | 2010-01-05 |
| 1528380474 | Ettore Pittore | Physical Therapist | 2195 Bosque Farms Blvd, Bosque Farms, NM 87068-8941 | 2010-02-19 |
| 1356712707 | Karolyn Armijo | Physical Therapy Assistant | 2195 Bosque Farms Blvd, Bosque Farms, NM 87068-8941 | 2015-10-12 |
| 1346472578 | Margie J Wesley, LLC | Acupuncturist | 1435 Bosque Farms Blvd, Bosque Farms, NM 87068-8952 | 2009-08-21 |
| 1326477696 | Joanne Keefe | Nurse Practitioner | 1715 Pearl Loop, Bosque Farms, NM 87068-9035 | 2013-11-06 |
| Find all providers in zip 87068 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326477696 | Joanne Keefe | Nurse Practitioner | 1715 Pearl Loop, Bosque Farms, NM 87068-9035 | 2013-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851845 | Jessica Montoya | Nurse Practitioner | 119 California Pine Rd Ne, Rio Rancho, NM 87124-2505 | 2020-11-03 |
| 1497354328 | Tracy Bui | Nurse Practitioner | 9200 Timber Ridge Rd Nw, Albuquerque, NM 87120-6278 | 2020-10-21 |
| 1477152619 | Aileen Liong | Nurse Practitioner | 3820 Dynamite Rd Ne, Rio Rancho, NM 87144-4160 | 2020-10-20 |
| 1578162822 | Holly Killough | Nurse Practitioner | 2332 Cottage San Rd, Silver City, NM 88061-8966 | 2020-10-19 |
| 1558969253 | Beverly Carter | Nurse Practitioner | 5021 Nelson Pl Nw, Albuquerque, NM 87114-4320 | 2020-10-14 |
| 1932706223 | Rozita Dayani | Nurse Practitioner | 6821 Promenade Ave Ne, Albuquerque, NM 87109-2824 | 2020-10-08 |
| 1730795626 | Jia Wu | Nurse Practitioner | 7124 Marseille Pl Ne, Albuquerque, NM 87122-3328 | 2020-09-17 |
| 1912513870 | Ariel A Nunez | Nurse Practitioner | 500 Walter Street Ne, Suite 216, Lovelace Medical Towers - Clinical Informatics, Albuquerque, NM 87102-2543 | 2020-09-16 |
| 1114531100 | Anneliese K. Glasgow | Nurse Practitioner | 2515 Tiffany Dr, Las Cruces, NM 88011-0880 | 2020-09-07 |
| 1326652173 | Matthew S Fogel | Nurse Practitioner | 3129 Casa Bonita Dr Ne, Albuquerque, NM 87111-5607 | 2020-08-31 |
| Find all providers with the same taxonomy | ||||
| City | BOSQUE FARMS |
| Zip Code | 87068 |
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| 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.