ROSWELL HOSPITAL (NPI# 1619902863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619902863 |
| Entity Type | Organization |
| Organization Name | ROSWELL HOSPITAL |
| Other Organization Name | EASTERN NEW MEXICO MEDICAL CENTER |
| Practice Address |
405 W Country Club Rd Roswell NM 88201-5209 |
| Practice Telephone | 5056228170 |
| Practice Fax Number | 5056248751 |
| Mailing Telephone | 5056228170 |
| Mailing Fax Number | 5056248751 |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MICHAEL PORTACCI (GROUP VP) |
| Authorized Official Telephone | 6154657000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
2002-0076 | NM | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Eastern New Mexico Medical Center | Doing Business As Name - Organization |
| Street Address |
405 W COUNTRY CLUB RD |
| City | ROSWELL |
| State | NM |
| Zip Code | 88201-5209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003802463 | Hany Nagy Yassa | Internal Medicine | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2005-09-21 |
| 1548880495 | Roswell Hospital Corporation | Clinical Medical Laboratory | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2020-04-21 |
| 1699306977 | Evan Brian Whipple | Nurse Anesthetist, Certified Registered | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2020-01-27 |
| 1457902215 | Capital Anesthesia Solutions of New Mexico LLC | Nurse Anesthetist, Certified Registered | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2019-09-24 |
| 1265081806 | Toni Pearce | Nurse Practitioner | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2019-09-06 |
| 1215408497 | Aanu Ogunbanjo | Hospitalist | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2018-12-16 |
| 1851875066 | Miao Yang | Registered Nurse | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2018-09-24 |
| 1053802892 | Ruben A. Supan, LLC | Nurse Practitioner | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2018-05-29 |
| 1295289437 | Truitt Radiation Oncology Services | Radiology | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2016-08-04 |
| 1447602834 | Arinola Odumusi | Internal Medicine | 405 W Country Club Rd, Roswell, NM 88201-5209 | 2016-07-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902310022 | Corey A Carter | Specialist/Technologist, Other | 117 E 19th Street, Roswell, NM 88201 | 2017-11-28 |
| 1326598541 | Dove Medical Corporation | Family Medicine | 110 East 3rd Street, Roswell, NM 88201 | 2016-10-12 |
| 1841748381 | Anali Velez | Registered Nurse | 300 N Kentucky, Roswell, NM 88201 | 2016-09-13 |
| 1831647379 | Rebecca Palomino | Registered Nurse | 800 Marion Richards Rd, Roswell, NM 88201 | 2016-09-13 |
| 1215300926 | Heart Path Oriental Medicine | Clinic/Center | 810 N Union, Roswell, NM 88201 | 2015-11-03 |
| 1538564745 | Lacey Scott | Pharmacist | 1835 N. Main, Roswell, NM 88201 | 2014-10-30 |
| 1962815852 | Marium Khan | Internal Medicine | 400 Military Heights Place, Roswell, NM 88201 | 2014-06-09 |
| 1316288913 | Anaya Counseling | Community/Behavioral Health | 613 W 2nd St Ste 4, Roswell, NM 88201 | 2013-03-06 |
| 1205185386 | Rosarita Brady | Occupational Therapist | 300 N. Kentucky, Roswell, NM 88201 | 2012-09-05 |
| 1922360049 | Ashley Spinhirne Thompson | Speech-Language Pathologist | 304 N. Richardson, Roswell, NM 88201 | 2012-06-14 |
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| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386283943 | Luxe Psychiatric and Wellness Services LLC | Psychiatry & Neurology | 613 W 2nd St Ste 3, Roswell, NM 88201-4671 | 2019-12-31 |
| 1780176891 | Michael J Rosen Md Pllc | Psychiatry & Neurology | 800 Old Roswell Lakes Pkwy Ste 250, Roswell, GA 30076-8614 | 2018-06-04 |
| 1063891307 | Lynnet M Bulambo | Psychiatry & Neurology | 613 W 2nd St # 1&3, Roswell, NM 88201-4671 | 2015-05-20 |
| 1265774830 | Paul Everett Beecham | Psychiatry & Neurology | 11457 Hackett Rd, Roswell, GA 30075-2307 | 2013-03-21 |
| 1053555359 | Amy Lee Hostetter | Psychiatry & Neurology | 115 Vickery St Ste 100, Roswell, GA 30075-4977 | 2009-04-30 |
| 1760675466 | Stephen Neil Kissinger | Psychiatry & Neurology | 2060 Riverside Rd, Roswell, GA 30076-4026 | 2007-08-26 |
| 1871623819 | Glen H Havens | Psychiatry & Neurology | 11113 Houze Rd, Suite 100, Roswell, GA 30076 | 2007-03-07 |
| 1437214350 | Consuelo Reddick | Psychiatry & Neurology | 77 E Crossville Rd, Ste. 206, Roswell, GA 30075-5815 | 2006-12-22 |
| 1093873432 | Osama S. Hindash | Psychiatry & Neurology | 801 Macy Dr, Roswell, GA 30076-6333 | 2006-12-05 |
| 1831273036 | Mohammad Ahmad | Psychiatry & Neurology | 1902 Macy Drive, Atlanta Behavioral Medicine Inc, Roswell, GA 30076 | 2006-10-24 |
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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.