PUEBLO OF JEMEZ (NPI# 1417082215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417082215 |
| Entity Type | Organization |
| Organization Name | PUEBLO OF JEMEZ |
| Practice Address |
110 Sheep Springs Way Jemez Pueblo NM 87024 |
| Mailing Address |
Po Box 279 Jemez Pueblo NM 87024-0279 |
| Practice Telephone | 5758347413 |
| Practice Fax Number | 5758347517 |
| Mailing Telephone | 5758347413 |
| Mailing Fax Number | 5758347517 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2018-04-05 |
| Authorized Official Name | NOHEMY ROSALES (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 5758343187 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | NA | NM | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 65337239 | 05 | |
| NM | MEDICAID CLINIC PHARMACY | 79737 | 01 |
| NM | NCPDP CLINIC PHARMACY | 3209308 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477676567 | Pueblo of Jemez | Clinic/Center | 110 Sheepsprings Way, Jemez Pueblo, NM 87024 | 2007-04-06 |
| 1609913961 | Pueblo of Jemez | Ambulance | 4535 Highway 4, Jemez Pueblo, NM 87024-0219 | 2007-01-30 |
| 1225346547 | Pueblo of Jemez | Clinic/Center | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2010-09-21 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PUEBLO OF JEMEZ HOUSING AUTHORITY | 4773 Highway 4, Jemez Pueblo, NM 87024 |
| Street Address |
110 SHEEP SPRINGS WAY |
| City | JEMEZ PUEBLO |
| State | NM |
| Zip Code | 87024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013008150 | Paul Raymond Gooris | Physician Assistant | 110 Sheep Springs Way, Jemez Pueblo, NM 87114 | 2006-09-27 |
| 1881239374 | Marlencia D Chee | Counselor | 110 Sheep Springs Way, Jemez Pueblo, NM 87024-0279 | 2019-11-08 |
| 1598276644 | Pamela D Logan | Nurse Practitioner | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2017-10-17 |
| 1750811600 | Helen Hallas Fredlund | Counselor | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2017-06-14 |
| 1184159600 | Ona Trujillo | Counselor | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2017-04-21 |
| 1740589555 | Randrick Laroy Souza | Social Worker | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2011-03-18 |
| 1225346547 | Pueblo of Jemez | Clinic/Center | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2010-09-21 |
| 1679721054 | Chadwyck R Bradley | Dentist | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2008-08-28 |
| 1669662979 | Peter Paul Pecos | Counselor | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2007-08-01 |
| 1114065232 | Nancy Maybeth Harvey | Registered Nurse | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2007-02-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104357003 | Lovelace Unm Rehabilitation Hospital LLC | Physical Therapist | 129 A Canal Street, Jemez Pueblo, NM 87024 | 2017-03-22 |
| 1245786565 | Alana Chinana | Technician, Other | 174 Good Spirits Rd., Jemez Pueblo, NM 87024 | 2016-08-28 |
| 1932482445 | Lovelace Health System LLC | Physical Therapist | 129-a Canal Street, Jemez Pueblo, NM 87024 | 2011-09-21 |
| 1750615506 | Angela Xaviera Torres | Dentist | 110 Sheep Springs Rd, Jemez Pueblo, NM 87024 | 2009-09-28 |
| 1629218631 | Carol Ann Vigil | Counselor | 110 Sheep Spring Rd., Jemez Pueblo, NM 87024 | 2009-03-03 |
| 1821233644 | Debra Ann Benalli | Counselor | 110 Sheep Springs Rd., Jemez Pueblo, NM 87024 | 2008-12-08 |
| 1477676567 | Pueblo of Jemez | Clinic/Center | 110 Sheepsprings Way, Jemez Pueblo, NM 87024 | 2007-04-06 |
| 1780727735 | Marietta Montoya | Contractor | 129 Canal Street, Jemez Pueblo, NM 87024 | 2007-02-15 |
| 1629116611 | Deyvonna Allison Gachupin | Pharmacy Technician | 110 Sheepsprings Rd, Jemez Pueblo, NM 87024 | 2007-02-02 |
| 1801934864 | Vonda J Baca | Registered Nurse | 110 Sheepsprings Way St, Jemez Pueblo, NM 87024 | 2007-02-02 |
| Find all providers in zip 87024 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225346547 | Pueblo of Jemez | Clinic/Center | 110 Sheep Springs Way, Jemez Pueblo, NM 87024 | 2010-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295350437 | Clinica Para Todos | Clinic/Center | 7345 Yorktown Ave Ne, Albuquerque, NM 87109-5070 | 2020-06-13 |
| 1649894544 | Hope Medical Services, LLC | Clinic/Center | 305 Faculty Ln, Corrales, NM 87048-8721 | 2020-06-05 |
| 1285260588 | Uptown Dermatology LLC | Clinic/Center | 8016 Constitution Pl Ne, Albuquerque, NM 87110-7628 | 2020-03-18 |
| 1194372789 | Las Clinicas Del Norte Incorporated | Clinic/Center | 1183 Diamond Dr Ste D, Los Alamos, NM 87544-2228 | 2019-08-20 |
| 1245798024 | Lovelace Health System, Inc. | Clinic/Center | 460 Saint Michaels Dr Ste 505, Santa Fe, NM 87505-7622 | 2019-03-11 |
| 1083188585 | Hearing and Vision Store | Clinic/Center | 8400 Menaul Blvd Ne Ste F, Albuquerque, NM 87112-2200 | 2019-01-17 |
| 1588136956 | Hope and Healing Counseling LLC | Clinic/Center | 5880 First St., Organ, NM 88052 | 2018-12-26 |
| 1811473978 | Presbyterian Medical Services | Clinic/Center | 282 Casa Blanca Rd, Casa Blanca, NM 87007 | 2018-07-12 |
| 1144733924 | Heights Family Wellness Center LLC | Clinic/Center | 5800 Mcleod Rd Ne Ste C, Albuquerque, NM 87109-2467 | 2017-11-14 |
| 1053850784 | Olive Tree Pharmacy, Co. | Clinic/Center | 1920 Westside Blvd Se Ste B, Rio Rancho, NM 87124-4893 | 2017-02-14 |
| Find all providers with the same taxonomy | ||||
| City | JEMEZ PUEBLO |
| Zip Code | 87024 |
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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.