GENESIS PHYSICIAN ASSOCIATES LLC (NPI# 1457802340) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457802340 |
| Entity Type | Organization |
| Organization Name | GENESIS PHYSICIAN ASSOCIATES LLC |
| Other Organization Name | GENESIS BLOOMFIELD CLINIC |
| Practice Address |
100 N Church St Unit C Bloomfield NM 87413-5754 |
| Mailing Address |
4801 N Butler Avenue Suite 8102 Farmington NM 87401-0818 |
| Practice Telephone | 5056092199 |
| Mailing Telephone | 5054362671 |
| Mailing Fax Number | 5054362673 |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |
| Authorized Official Name | UCHE OBISIKE (PRESIDENT) |
| Authorized Official Telephone | 5058017137 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD2006-0141 | NM | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Genesis Bloomfield Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740569763 | Genesis Physician Associates LLC | Internal Medicine | 4801 N Butler Avenue, Suite 8102, Farmington, NM 87401-0818 | 2011-08-08 |
| 1902465263 | Genesis Physician Associates LLC | Internal Medicine | 9201 Montgomery Blvd Ne Ste 301, Albuquerque, NM 87111-2467 | 2019-06-11 |
| Street Address |
100 N CHURCH ST UNIT C |
| City | BLOOMFIELD |
| State | NM |
| Zip Code | 87413-5754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609326123 | Kimberly Pappas | Nurse Practitioner | 100 N Church St, Unit C, Bloomfield, NM 87413-5754 | 2016-10-07 |
| 1417982679 | Frank Wendell Arnold | Family Medicine | 100 N Church St, Suite C, Bloomfield, NM 87413-5754 | 2006-07-12 |
| 1215906003 | Tracy Reavis | Physician Assistant | 100 N Church St, Ste C, Bloomfield, NM 87413-5754 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396057 | Heather Smith | Behavior Technician | 25a Cr 5060, Bloomfield, NM 87413 | 2020-11-04 |
| 1104292325 | Michelle Childers-beck | Social Worker | 235 N Bergin Lane, Bloomfield, NM 87413 | 2015-08-12 |
| 1427364090 | Marichu Lazo | Occupational Therapy Assistant | 803 Hacienda Lane, Bloomfield, NM 87413 | 2010-08-20 |
| 1023344181 | Sundance Dental Care of Bloomfield, LLC. | Dentist | 100 South First Street, Bloomfield, NM 87413 | 2009-10-26 |
| 1972838266 | Chris Dwight Richardson | Physical Therapy Assistant | #6 Cty Rd 5149, Bloomfield, NM 87413 | 2009-10-05 |
| 1710025028 | Roy Hernandez | Speech-Language Pathologist | 325 North Bergin Lane, Bloomfield, NM 87413 | 2007-02-01 |
| 1760427587 | Dhhs, Phs, Naihs, Shiprock Hospital | Clinic/Center | 6 Road 7586, Bloomfield, NM 87413 | 2006-06-17 |
| 1568500833 | Connie Hernandez | Speech-Language Pathologist | 325 North Bergin Lane, Bloomfield, NM 87413-2430 | 2007-02-01 |
| 1841453636 | James Bellah | Family Medicine | 6 County Road 7586, Bloomfield, NM 87413-4934 | 2008-07-02 |
| 1598751778 | David Lynn Doss | Optometrist | 6 Road 7586, Bloomfield, NM 87413-4934 | 2005-09-23 |
| Find all providers in zip 87413 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1588264659 | Urgent Care Center of Bloomfield Pllc | Internal Medicine | 699 Cottage Grove Rd, Bloomfield, CT 06002-3059 | 2020-10-28 |
| 1023524550 | Cp Primary Care PC | Internal Medicine | 206 Belleville Ave Ste 204a, Bloomfield, NJ 07003-3589 | 2017-12-20 |
| 1801307871 | Nidhi Shishu | Internal Medicine | 4521 River Trl, Bloomfield, MI 48301-3642 | 2017-10-18 |
| 1669995247 | Oksana Kloyzner,md LLC | Internal Medicine | 701 Cottage Grove Rd Ste F, Bloomfield, CT 06002-3080 | 2017-07-25 |
| 1710431291 | Clark Medical Service LLC | Internal Medicine | 135 Bloomfield Ave Ste F, Bloomfield, NJ 07003-5902 | 2016-08-12 |
| 1861806721 | Arhin Internal Medicine Clinic LLC | Internal Medicine | 35 Jolley Dr # 201, Bloomfield, CT 06002-3062 | 2014-06-18 |
| 1013276062 | Esira Jaimie Beaubrun | Internal Medicine | 323 Belleville Ave Fl 2, Bloomfield, NJ 07003-3648 | 2012-05-11 |
| 1801178389 | Robert Jay Dobrow | Internal Medicine | 15 Cherry Hills Cir, Bloomfield, CT 06002-2919 | 2011-09-12 |
| 1285952960 | Leandro Lencina | Internal Medicine | 85 E Passaic Ave, Bloomfield, NJ 07003-3752 | 2010-05-05 |
| 1336314475 | Roy A. Kellerman, Md, LLC | Internal Medicine | 701 Cottage Grove Rd Ste A110, Bloomfield, CT 06002-3082 | 2008-04-29 |
| Find all providers in BLOOMFIELD | ||||
| City | BLOOMFIELD |
| Zip Code | 87413 |
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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.