SAN MIGUEL HOSPITAL CORPORATION (NPI# 1396716643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396716643 |
| Entity Type | Organization |
| Organization Name | SAN MIGUEL HOSPITAL CORPORATION |
| Other Organization Name | ALTA VISTA REGIONAL HOSPITAL |
| Practice Address |
104 Legion Dr Las Vegas NM 87701-4804 |
| Practice Telephone | 5054263500 |
| Practice Fax Number | 5054549502 |
| Mailing Telephone | 5054263500 |
| Mailing Fax Number | 5054549502 |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | RANDY MICHAEL COOPER (SVP FINANCE OP/AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 6152213840 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 3005 | NM | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PHP | 24644 | 01 | |
| NM | BCBS | NM000068 | 01 |
| NM | 76546 | 05 | |
| PHP SALUD | 24622 | 01 |
| Other Name | Type Code |
|---|---|
| Alta Vista Regional Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184193450 | San Miguel Hospital Corporation | Clinic/Center | 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972 | 2018-11-16 |
| 1851747216 | San Miguel Hospital Corporation | General Practice | 2515 Ridge Runner Rd, Las Vegas, NM 87701-4972 | 2016-05-04 |
| 1609041706 | San Miguel Hospital Corporation | Anesthesiology | 104 Legion Dr, Las Vegas, NM 87701-4808 | 2008-04-29 |
| 1487625257 | San Miguel Hospital Corporation | Medicare Defined Swing Bed Unit | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2006-01-30 |
| Street Address |
104 LEGION DR |
| City | LAS VEGAS |
| State | NM |
| Zip Code | 87701-4804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336132786 | Marianne M. Luchini | Family Medicine | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2005-08-31 |
| 1679112130 | Summit Emergency Medicine LLC | Emergency Medicine | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2020-01-02 |
| 1689105520 | Julia Stevens | Radiologic Technologist | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2017-03-22 |
| 1659765303 | Beachsalmon Emergency Physicians LLC | Emergency Medicine | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2015-03-20 |
| 1568852861 | Deana Marie Benjamin | Physical Therapist | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2015-01-26 |
| 1164756862 | San Miguel Physician Services LLC | Hospitalist | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2009-09-28 |
| 1609041706 | San Miguel Hospital Corporation | Anesthesiology | 104 Legion Dr, Las Vegas, NM 87701-4808 | 2008-04-29 |
| 1881882439 | Gallinas Emergency Physicians | Emergency Medicine | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2007-10-09 |
| 1174749964 | Advanced Anesthesia Care P.C. | Specialist | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2007-04-18 |
| 1770607244 | Monica Renee Aragon | Pharmacist | 104 Legion Dr, Las Vegas, NM 87701-4804 | 2007-03-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851884423 | Nueva Vida Counseling and Consulting Services LLC | Community/Behavioral Health | Nueva Vida Counseling & Consulting Services LLC, 1920 7th Street, Las Vegas, NM 87701 | 2018-06-08 |
| 1316475403 | El Centro Family Health | Family Medicine | 475 Legion Dr., Las Vegas, NM 87701 | 2017-06-01 |
| 1700327384 | Anastacia Sena Jaramillo | Psychologist | 126 Silva Ave., Las Vegas, NM 87701 | 2017-03-15 |
| 1013369222 | Home Medical Equipment Specialists,llc | Durable Medical Equipment & Medical Supplies | 514 8th Street, Las Vegas, NM 87701 | 2016-07-12 |
| 1750730826 | John Michael Tourangeau | Social Worker | 1920 7th Street, Las Vegas, NM 87701 | 2016-06-08 |
| 1154705689 | Lindsy Laura Kragt Allen | Podiatrist | 1608 7th St, Las Vegas, NM 87701 | 2015-07-14 |
| 1023409521 | Ambercare Medical Supply | Durable Medical Equipment & Medical Supplies | 1747 N Grand Ave, Las Vegas, NM 87701 | 2015-02-05 |
| 1538561964 | El Centro Family Health | Clinic/Center | 947 Old National Road, Las Vegas, NM 87701 | 2014-09-17 |
| 1164832150 | Plaza Drugs | Pharmacist | 178 Bridge St, Las Vegas, NM 87701 | 2014-04-30 |
| 1043648165 | Open Doors Home Health Care | Home Health | 713 Railroad Ave., Las Vegas, NM 87701 | 2013-10-29 |
| Find all providers in zip 87701 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922605229 | Ronald Kenan | General Acute Care Hospital | 533 Shewsbury Ave, Las Vegas, NV 89178-2414 | 2020-10-08 |
| 1407363070 | Hirk LLC | General Acute Care Hospital | 7220 Mira Vista St, Las Vegas, NV 89120-3025 | 2018-01-04 |
| 1457895336 | De Craig Ranch, LLC | General Acute Care Hospital | 4980 W Sahara Ave, Las Vegas, NV 89102 | 2016-12-12 |
| 1922542968 | De Craig Ranch, LLC | General Acute Care Hospital | 4855 Blue Diamond Rd, Las Vegas, NV 89139 | 2016-12-09 |
| 1346604790 | Jean-marie Swaine, LLC | General Acute Care Hospital | 2450 Granada Bluff Ct, Las Vegas, NV 89135-1341 | 2016-04-12 |
| 1023479755 | Anesthesiology Consultants, Inc | General Acute Care Hospital | 7220 S Cimarron Rd Ste 230, Las Vegas, NV 89113-2173 | 2016-03-08 |
| 1336540491 | Vegas Hospital Care LLC | General Acute Care Hospital | 8656 W Patrick Lane, Las Vegas, NV 89148 | 2014-09-09 |
| 1639585912 | Roy Gradney | General Acute Care Hospital | 2929 Cape Verde Ln, Las Vegas, NV 89128-7237 | 2014-07-07 |
| 1487771812 | Centennial Hills Hospital Medical Center | General Acute Care Hospital | 6900 N Durango Drive, Las Vegas, NV 89149 | 2007-03-22 |
| 1558453571 | Veterans Administration | General Acute Care Hospital | 5516 Vansville Way, Las Vegas, NV 89130-3601 | 2006-09-28 |
| Find all providers in LAS VEGAS | ||||
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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.