THERESA MARY ALONZO (NPI# 1730262783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730262783 |
| Entity Type | Individual |
| Full Name | THERESA MARY ALONZO |
| Credential | RT LAB TECH |
| Practice Address |
12000 Stone Lake Road Dulce NM 87528-0187 |
| Mailing Address |
Po Box 187 12000 Stone Lake Road Dulce NM 87528-0187 |
| Practice Telephone | 5057593291 |
| Practice Fax Number | 5057593532 |
| Mailing Telephone | 5057593291 |
| Mailing Fax Number | 5057593532 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2008-06-16 |
| NPI Deactivation Date | 07/17/2007 |
| NPI Reactivation Date | 2008-06-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | $$$$$$$$$ | NM | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 000K3526 | 05 | |
| NM | MEDICARE PART B | HSZ196 | 01 |
| Street Address |
12000 STONE LAKE ROAD |
| City | DULCE |
| State | NM |
| Zip Code | 87528-0187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568453702 | Richard Allen March | Physician Assistant | 12000 Stone Lake Road, Dulce, NM 97528-3291 | 2005-11-04 |
| 1770809527 | Ursula Michael Gabriel | Nurse's Aide | 12000 Stone Lake Road, Dulce, NM 87528 | 2010-04-19 |
| 1467778365 | Cynthia M. Montanez | Registered Nurse | 12000 Stone Lake Road, Jicarilla Service Unit, Dulce, NM 87528 | 2010-04-16 |
| 1184946626 | Inna Voinich | Pharmacist | 12000 Stone Lake Road, Dulce, NM 87528-0187 | 2010-02-25 |
| 1548597743 | Dhhs/ihs/aao/jsu/dulce Health Center | Clinic/Center | 12000 Stone Lake Road, Jicarilla Service Unit, Dulce, NM 87528 | 2009-11-09 |
| 1619117116 | Darlene Peshlakai Valdez | Nurse's Aide | 12000 Stone Lake Road, Dulce, NM 87528 | 2009-02-24 |
| 1487805198 | Anna V. Hall | Spec/Tech, Pathology | 12000 Stone Lake Road, Dulce, NM 87528-0187 | 2008-10-01 |
| 1629228507 | Marcia Ann Sahmaunt | Technician, Pathology | 12000 Stone Lake Road, Dulce, NM 87528 | 2008-09-26 |
| 1851550776 | Diana Connell | Registered Nurse | 12000 Stone Lake Road, Dulce, NM 87528-0187 | 2008-06-05 |
| 1043479330 | E Joan Wilson | Specialist/Technologist, Other | 12000 Stone Lake Road, Dulce, NM 87528 | 2008-06-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164917373 | Kelly Rae Pettigrew | Optometrist | 505 North Mundo, Dulce, NM 87528 | 2018-06-29 |
| 1780003442 | Jacob Alexander | Preventive Medicine | 500 N. Mundo, Dulce, NM 87528 | 2014-04-09 |
| 1881020089 | Jicarilla Apache Nation | Clinic/Center | 450 N Mundo Dr., Dulce, NM 87528 | 2013-09-19 |
| 1285971515 | Samuel Taylor Cropp | Pharmacist | 500 N Mundo Dr, Dulce, NM 87528 | 2013-01-07 |
| 1720331697 | Northwest Reional Education Coop #2 | Student in an Organized Health Care Education/Training Program | 91 Hawk Drive, Dulce, NM 87528 | 2012-10-17 |
| 1306116066 | Michael Shawn Kennedy | Psychologist | 113 Hawk Dr, Dulce, NM 87528 | 2012-01-11 |
| 1669762043 | Veronica A Medlin | Technician, Pathology | 1200 Stone Lake Rd, Dulce, NM 87528 | 2011-04-19 |
| 1891085262 | Stella Elizabeth Wilson | Spec/Tech, Pathology | 500 Stone Lake Road, Dulce, NM 87528 | 2011-04-19 |
| 1134419518 | Ray Morris Joe | Technician, Pathology | 500 North Mundo Road, Dulce, NM 87528 | 2011-04-19 |
| 1801186341 | Raquel Irene Cisneros | Family Medicine | 500 N. Mundo Dr., Dulce, NM 87528 | 2011-04-18 |
| Find all providers in zip 87528 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477628659 | Indian Health Service- Jicarilla Service Unit | Clinical Medical Laboratory | 12000 Stone Lake Drive, Dulce, NM 87528-0187 | 2006-11-22 |
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| 1740615855 | Elizabeth Amanda Stenger | Clinical Medical Laboratory | 10444 Calle Avila Nw, Albuquerque, NM 87114-1804 | 2013-09-08 |
| 1821381773 | Alethea Laboratories Inc | Clinical Medical Laboratory | 410 E. Foster Road, Las Cruces, NM 88005-3209 | 2011-05-25 |
| 1083946222 | Metwest Inc | Clinical Medical Laboratory | 1121 Mall Dr, Las Cruces, NM 88011-8102 | 2010-02-12 |
| 1467783753 | Matrix Genomics, Inc. | Clinical Medical Laboratory | 3900 Paseo Del Sol, Santa Fe, NM 87507-4072 | 2010-01-26 |
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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.