SOUTHERN NEW MEXICO NEUROSURGERY LLC (NPI# 1558558726) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558558726 |
| Entity Type | Organization |
| Organization Name | SOUTHERN NEW MEXICO NEUROSURGERY LLC |
| Practice Address |
3850 E Lohman Ave Ste C Las Cruces NM 88011-8288 |
| Mailing Address |
Po Box 13668 Las Cruces NM 88013-3668 |
| Practice Telephone | 5755221974 |
| Practice Fax Number | 5755225209 |
| Mailing Telephone | 5755221974 |
| Mailing Fax Number | 5755225209 |
| Enumeration Date | 2007-10-01 |
| Last Update Date | 2015-06-26 |
| Authorized Official Name | DR. BRETT R. HENDERSON (PRESIDENT) |
| Authorized Official Telephone | 5755221974 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 21709751 | 05 | |
| RR MEDICARE | DG08655 | 01 | |
| NM | BCBS OF NM | NM007L05 | 01 |
| Street Address |
3850 E LOHMAN AVE STE C |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88011-8288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750862785 | Advanced Vascular Testing, LLC | Physiological Laboratory | 3850 E Lohman Ave Ste C, Las Cruces, NM 88011 | 2018-08-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954648 | Asc of The Heart Institute | Internal Medicine | 1250 N Sonoma Ranch Blvd, Las Cruces, NM 88011 | 2020-08-26 |
| 1104449206 | Kruti Gitesh Shah | Student in an Organized Health Care Education/Training Program | Mountain View Regional Medical Cente, Graduate Medical Education, 4351 E Lohman Ave Suite 300, Las Cruces, NM 88011 | 2020-05-22 |
| 1831719368 | Borna Mansouri | Student in an Organized Health Care Education/Training Program | 4351 E. Lahman Ave, Suite 300, Moutnainview Regional Medical Center Graduta, Las Cruces, NM 88011 | 2020-04-24 |
| 1306474408 | Madonna Petula Phillip | Student in an Organized Health Care Education/Training Program | 4351 E Lohmon Avenue Suite 300, Las Cruces, NM 88011 | 2020-04-01 |
| 1285267849 | Back In Action Therapy of Las Cruces | Occupational Therapist | 4440 Sonoma Ranch Blvd, Suite F, Las Cruces, NM 88011 | 2020-02-21 |
| 1649818725 | Kimberly Ann Smetzer | Registered Nurse | 4401 East Lohman, Building 5, Las Cruces, NM 88011 | 2019-12-19 |
| 1548806375 | Melinda Michelle Fowler | Social Worker | 2605 Terrace Drive, Las Cruces, NM 88011 | 2019-11-27 |
| 1871134692 | Rio Grande Hematology and Oncology, LLC | Internal Medicine | 4391 East Lohman Ave., Las Cruces, NM 88011 | 2019-10-02 |
| 1972083640 | Lorianna R. Narvaez | Counselor | 1155 S. Telshor Suite 302-a, Las Cruces, NM 88011 | 2018-08-21 |
| 1215416524 | Aday Orthodontics, PC | Dentist | 2701 Missouri Ave., Suite D, Las Cruces, NM 88011 | 2018-08-08 |
| Find all providers in zip 88011 | ||||
| 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 |
|---|---|---|---|---|
| 1528043783 | Jose V Santos Pico | Neurological Surgery | 4351 E Lohman Ave Ste 409, Las Cruces, NM 88011-8263 | 2005-12-09 |
| 1598818189 | Brett R Henderson | Neurological Surgery | 3850 E Lohman Ave, Suite C, Las Cruces, NM 88011-8288 | 2007-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669929485 | Avra Sophia Saskia Laarakker | Neurological Surgery | Msc Plastic Surgery 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2016-09-09 |
| 1447639109 | Ross Steven Green | Neurological Surgery | Msc10 5615, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2015-05-27 |
| 1023315959 | Gerald Nathan Gold | Neurological Surgery | 1509 Harvard Ct Ne, Albuquerque, NM 87106-3712 | 2011-02-10 |
| 1487897542 | Christian Andrew Bowers | Neurological Surgery | Unm Neurosurgery Msc10 5615, Albuquerque, NM 87131-1530 | 2009-04-19 |
| 1609076660 | Patricia L Gando | Neurological Surgery | Graduate Medical Education Msc08 4770, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2007-07-18 |
| 1730228750 | Hoan Phan Tran | Neurological Surgery | Unm Hospital Neurological Surgery, 2211 Lomas Blvd Ne, Albuquerque, NM 87131-0001 | 2007-02-06 |
| 1568522035 | Peter C. Shin | Neurological Surgery | Msc 10 5615, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2006-12-12 |
| 1588758965 | Erich P Marchand | Neurological Surgery | 531 Harkle Rd Ste D, Pmg Neurosurgery Santa Fe, Santa Fe, NM 87505-4753 | 2006-10-03 |
| 1306954193 | Richard C Branan | Neurological Surgery | 33 Eagle Crest Dr., Tijeras, NM 87059-0910 | 2006-08-29 |
| 1386650877 | Paul Turner | Neurological Surgery | 5-north University Hospital, 2211 Lomas Blvd. Ne, Albuquerque, NM 87131-0001 | 2006-08-01 |
| Find all providers with the same taxonomy | ||||
| City | LAS CRUCES |
| Zip Code | 88011 |
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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.