OTERO COUNTY MEDICAL GROUP (NPI# 1487080776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487080776 |
| Entity Type | Organization |
| Organization Name | OTERO COUNTY MEDICAL GROUP |
| Other Organization Name | GCRMC GENERAL AND VASCULAR SURGERY |
| Practice Address |
1212 9th St Suite A Alamogordo NM 88310-5842 |
| Mailing Address |
2689 Scenic Dr Alamogordo NM 88310-8700 |
| Practice Telephone | 5754342613 |
| Mailing Telephone | 5754341699 |
| Mailing Fax Number | 5754348871 |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2013-09-19 |
| Authorized Official Name | MR. ROBERT JAMES HECKERT (CEO) |
| Authorized Official Telephone | 5754437845 |
| Authorized Official Credential | FACHE |
| Is Organization Subpart | Y |
| Parent Organization Name | OTERO COUNTY MEDICAL GROUP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| GCRMC General and Vascular Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558797746 | Otero County Medical Group | Obstetrics & Gynecology | 2050 Scenic Dr, Alamogordo, NM 88310-3880 | 2013-09-19 |
| 1376978577 | Otero County Medical Group | Psychologist | 2689 Scenic Dr, Alamogordo, NM 88310-8700 | 2013-09-06 |
| 1528494747 | Otero County Medical Group | Radiology | 2559 Medical Dr, Suite G, Alamogordo, NM 88310-8703 | 2013-09-19 |
| 1932535127 | Otero County Medical Group | Family Medicine | 1401 10th St, Alamogordo, NM 88310-5012 | 2013-09-19 |
| 1467888651 | Otero County Medical Group | Surgery | 1100 10th St, Alamogordo, NM 88310-6414 | 2013-09-19 |
| 1639505829 | Otero County Medical Group | Nurse Practitioner | 2539 Medical Dr, Suite 107, Alamogordo, NM 88310-8720 | 2013-09-19 |
| 1831525120 | Otero County Medical Group | Internal Medicine | 2689 Scenic Dr, Alamogordo, NM 88310-8700 | 2013-09-19 |
| 1346676566 | Otero County Medical Group | Internal Medicine | 2689 Scenic Dr, Alamogordo, NM 88310-8700 | 2013-09-19 |
| 1275969495 | Otero County Medical Group | Family Medicine | 1101 9th St, Suite A, Alamogordo, NM 88310-6432 | 2013-09-19 |
| 1093141491 | Otero County Medical Group | Orthopaedic Surgery | 2539 Medical Dr, Suite 110, Alamogordo, NM 88310-8720 | 2013-09-18 |
| Street Address |
1212 9TH ST SUITE A |
| City | ALAMOGORDO |
| State | NM |
| Zip Code | 88310-5842 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740224500 | Jagdev I Singh | Family Medicine | 1212 9th St, Ste Bc, Alamogordo, NM 88310-5842 | 2006-06-15 |
| 1770082984 | Charlotte Dubois | Nurse Practitioner | 1212 9th St, Alamogordo, NM 88310 | 2018-02-03 |
| 1356776520 | Otero County Medical Group | Surgery | 1212 9th St, Suite C, Alamogordo, NM 88310-5842 | 2013-09-06 |
| 1568776730 | Elizabeth M Tucker Do PC | Surgery | 1212 9th St, Suite A, Alamogordo, NM 88310-5842 | 2010-07-30 |
| 1669696951 | Tularosa Basin Dermatology | Specialist | 1212 9th St, Suite A, Alamogordo, NM 88310-5842 | 2007-04-11 |
| 1275614935 | Elizabeth M Tucker | Surgery | 1212 9th St, Suite A, Alamogordo, NM 88310-5842 | 2006-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285249326 | Diana Cano | Behavior Technician | 27 N. Yucca Ave, Alamogordo, NM 88310 | 2020-09-15 |
| 1952802787 | Kinfe H Alemnugus | Pharmacist | 2669 N Scenic Dr, Inpatient Pharmacy, Alamogordo, NM 88310 | 2018-02-27 |
| 1134666902 | Hillary Elizabeth Hunter | Behavior Technician | 1908 Snow Dr, Alamogordo, NM 88310 | 2017-01-31 |
| 1285097774 | Adrienne Nicole Martin | Physician Assistant | 1501 E 10th Street, Pms-alamogordo Family Health Center, Alamogordo, NM 88310 | 2016-04-01 |
| 1487022919 | Crystal Jackson | Behavior Technician | 3205 Shawnee Trl, Alamogordo, NM 88310 | 2015-09-15 |
| 1851788798 | Timothy W. Basha | Counselor | 1613 Juniper Dr., Alamogordo, NM 88310 | 2015-04-17 |
| 1215331186 | Keith Edward Gerber | Case Manager/Care Coordinator | 1900 East Tenth Street, Alamogordo, NM 88310 | 2014-10-21 |
| 1710306691 | Austin Reed | Pharmacist | 2401 Indian Wells, Alamogordo, NM 88310 | 2014-04-08 |
| 1760821805 | Dollar Cab Company | Taxi | 1220 Brooks Ave., Alamogordo, NM 88310 | 2013-06-21 |
| 1932544319 | Peter Allan Lock | Physical Therapist | 1011 A 10th Street, Alamogordo, NM 88310 | 2013-04-30 |
| Find all providers in zip 88310 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003180969 | Kristen L. Biggs, Md, Skin Care & Vein Centre, PC | Surgery | 409 Saint Michaels Dr, Santa Fe, NM 87505-7603 | 2012-02-23 |
| 1861665051 | Kristen Lynn Biggs | Surgery | 450 Saint Michaels Dr, Santa Fe, NM 87505-7602 | 2008-04-08 |
| 1407031040 | Gopal Reddy M.d., P.C. | Surgery | 500 Walter St Ne Ste 204, Albuquerque, NM 87102-2543 | 2008-01-02 |
| 1487787545 | Alfred Joseph Martin Jr. | Surgery | 4013 Old Santa Fe Trl, Santa Fe, NM 87505-4503 | 2007-03-14 |
| 1396799110 | Milagro Vein Solutions LLC | Surgery | 490b W Zia Road, Suite A, Santa Fe, NM 87505 | 2006-05-19 |
| 1437158003 | Charles Anthony Dow | Surgery | 4407 E Lohman Ave, Las Cruces, NM 88011-8267 | 2005-07-18 |
| 1942554480 | Sandya Surgical Associates | Surgery | 2402 W Pierce St, Suite 5c, Carlsbad, NM 88220-3537 | 2012-11-06 |
| 1093022402 | Robert Moskowitz | Surgery | 201 Cedar St Se Ste 800, Albuquerque, NM 87106 | 2010-09-07 |
| 1093947491 | Las Cruces Physician Practices, LLC | Surgery | 4351 E Lohman Ave, Suite 403, Las Cruces, NM 88011-8259 | 2009-08-18 |
| 1588863120 | Muhammad Ali A Rana | Surgery | 2211 Lomas Blvd Ne, Department of Surgery, Albuquerque, NM 87106-2719 | 2007-07-13 |
| Find all providers with the same taxonomy | ||||
| City | ALAMOGORDO |
| Zip Code | 88310 |
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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.