SAN JUAN REGIONAL MEDICAL CENTER INC (NPI# 1427076298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427076298 |
| Entity Type | Organization |
| Organization Name | SAN JUAN REGIONAL MEDICAL CENTER INC |
| Other Organization Name | SAN JUAN REGIONAL NEUROSCIENCES |
| Practice Address |
407 S Schwartz Ave Suite 202 Farmington NM 87401 |
| Mailing Address |
Po Box 6210 Farmington NM 87499-6210 |
| Practice Telephone | 5056096595 |
| Practice Fax Number | 5056096579 |
| Mailing Telephone | 5056092258 |
| Mailing Fax Number | 5056092259 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | KAREN S MILLER (CSO) |
| Authorized Official Telephone | 5056096114 |
| Is Organization Subpart | Y |
| Parent Organization Name | SAN JUAN REGIONAL MEDICAL CENTER INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 000T8636 | 05 |
| Other Name | Type Code |
|---|---|
| SAN JUAN REGIONAL NEUROSCIENCES | Doing Business As Name - Organization |
| San Juan Regional Neurosciences / Spine Center | Doing Business As Name - Organization |
| 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 | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134579451 | Chad Claus | Neurological Surgery | 21080 Birchwood St, Farmington, MI 48336-5006 | 2016-06-17 |
| 1225020894 | Paul Francis Davis | Neurological Surgery | 407 S Schwartz Ave Ste 101, Farmington, NM 87401-5925 | 2005-08-18 |
| 1609879519 | Michael Joseph Giordano | Neurological Surgery | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-05-24 |
| 1730409541 | David Choi | Neurological Surgery | 263 Farmington Avenue, Farmington, CT 06030 | 2010-06-03 |
| 1730361031 | State of Connecitut Health Center | Neurological Surgery | 263 Farmington Ave, Neurosurgery Associates, Farmington, CT 06030-0001 | 2007-11-29 |
| 1780888529 | Ketan Ramanlal Bulsara | Neurological Surgery | 263 Farmington Avenue, Farmington, CT 06030 | 2007-06-14 |
| 1629001060 | Southwest Neurosurgery PC | Neurological Surgery | 555 S Schwartz Ave, Farmington, NM 87401-5955 | 2006-07-09 |
| 1336191477 | Dominic Michael Cannella | Neurological Surgery | 407 S Schwartz Ave Ste 101, Farmington, NM 87401-5925 | 2006-05-17 |
| 1851398234 | Richard Simon | Neurological Surgery | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-06-30 |
| 1336146992 | Hilary C Onyiuke | Neurological Surgery | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-06-28 |
| 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.