KEWA PUEBLO HEALTH CORPORATION (NPI# 1467739888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467739888 |
| Entity Type | Organization |
| Organization Name | KEWA PUEBLO HEALTH CORPORATION |
| Other Organization Name | SANTO DOMINGO HEALTH CENTER |
| Practice Address |
85 W Highway 22 Santo Domingo Pueblo NM 87052-0559 |
| Mailing Address |
Po Box 559 Santo Domingo Pueblo NM 87052-0559 |
| Practice Telephone | 5054653060 |
| Practice Fax Number | 5054651191 |
| Mailing Telephone | 5054653060 |
| Mailing Fax Number | 5054651191 |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |
| Authorized Official Name | VANESSA DIANA VIGIL (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 5054653060 |
| Is Organization Subpart | Y |
| Parent Organization Name | KEWA PUEBLO HEALTH CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 03217726007 | NM | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Santo Domingo Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336659077 | Kewa Pueblo Health Corporation | Community/Behavioral Health | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2017-10-09 |
| 1679842983 | Kewa Pueblo Health Corporation | Non-emergency Medical Transport (VAN) | 85 W Highway 22, Santo Domingo, NM 87052 | 2011-12-16 |
| 1902183155 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1811274061 | Kewa Pueblo Health Corporation | Clinical Medical Laboratory | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1194002345 | Kewa Pueblo Health Corporation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1003193251 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1558648709 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1467739615 | Kewa Pueblo Health Corporation | Optometrist | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| Street Address |
85 W HIGHWAY 22 |
| City | SANTO DOMINGO PUEBLO |
| State | NM |
| Zip Code | 87052-0559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902353972 | Karin Luzzi | Registered Nurse | 100 Highway 22 W, Santo Domingo, NM 87052 | 2016-09-07 |
| 1043676273 | Kyle Maestas | Physician Assistant | 85 West Hwy 22, Santo Domingo, NM 87052 | 2016-01-04 |
| 1639579352 | Cynthia Brooks | Registered Nurse | 85 West Highway 22 Santo Domingo Health Center, Santo Domingo, NM 87052 | 2014-08-29 |
| 1720335219 | Samantha Nicole Torres | Pharmacist | 85 W Hwy 22, Santo Domingo, NM 87052 | 2012-08-14 |
| 1780835504 | Roger L Leonard | Clinic/Center | #85 West Hwy 22, Santo Domingo, NM 87052 | 2008-10-10 |
| 1679766489 | Santo Domingo Tribe | Ambulance | #1 Tesuque St., Ems Headquarters, Santo Domingo Pueblo, NM 87052 | 2007-08-24 |
| 1326165994 | Santa Domingo Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 340 San Ildefonso St, Santa Domingo, NM 87052 | 2007-03-26 |
| 1467509612 | Andrea Heeter | Specialist/Technologist | Santo Domingo Health Center, 85 Hwy 22, Santo Domingo, NM 87052 | 2007-01-03 |
| 1164531950 | Jonathan Neil Trujillo | Pharmacist | 85 West Highway 22, Santo Domingo Health Center, Santo Domingo, NM 87052 | 2006-08-29 |
| 1053920520 | John Patirck Pagett | Registered Nurse | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2020-07-30 |
| Find all providers in zip 87052 | ||||
| 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 |
|---|---|---|---|---|
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| 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 | SANTO DOMINGO PUEBLO |
| Zip Code | 87052 |
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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.