LAS CRUCES PHYSICIAN PRACTICES, LLC (NPI# 1770766768) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770766768 |
| Entity Type | Organization |
| Organization Name | LAS CRUCES PHYSICIAN PRACTICES, LLC |
| Other Organization Name | MMC RADIOLOGY |
| Practice Address |
2450 S Telshor Blvd Las Cruces NM 88011-5069 |
| Mailing Address |
Po Box 6310 Las Cruces NM 88006-6310 |
| Practice Telephone | 5055215277 |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |
| Authorized Official Name | ANGIE MANGUM (DIRECTOR PHYSICIAN SERVICES) |
| Authorized Official Telephone | 5055215277 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MMC Radiology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346586195 | Las Cruces Physician Practices, LLC | Internal Medicine | 1160 Mall Dr, Suite 100, Las Cruces, NM 88011-8128 | 2012-12-26 |
| 1376866947 | Las Cruces Physician Practices, LLC | Surgery | 2530 S Telshor Blvd, Las Cruces, NM 88011-4907 | 2010-03-10 |
| 1093947491 | Las Cruces Physician Practices, LLC | Surgery | 4351 E Lohman Ave, Suite 403, Las Cruces, NM 88011-8259 | 2009-08-18 |
| 1356390769 | Las Cruces Physician Practices, LLC | Physician Assistant | 2530 S Telshor Blvd, Suite 107, Las Cruces, NM 88011 | 2006-05-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LAS CRUCES PHYSICIAN PRACTICES, LLC | 2530 S Telshor Blvd Ste 207, Las Cruces, NM 88011-4975 |
| Street Address |
2450 S TELSHOR BLVD |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88011-5069 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619973187 | Jenifer Lichtenfels | Pediatrics | 2450 S Telshor Blvd, Las Cruces, NM 88011-5141 | 2005-06-21 |
| 1669080560 | Leonard Nathaniel Sampath | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-07-16 |
| 1396362034 | Sartaj Singh Brar | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-29 |
| 1497372387 | Alexander Topete | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5076 | 2020-06-26 |
| 1619594421 | Eva Roxanna Campos | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-26 |
| 1437774759 | Bryan Wellington Messenger | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-12 |
| 1558986745 | Anthony Cohn | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5076 | 2020-06-12 |
| 1205451739 | Elena Liang Liang | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-10 |
| 1750906285 | Nagapavani Kandagari | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-10 |
| 1205450293 | Temitope Ade-oshifogun | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-04 |
| Find all providers in the same location | ||||
| 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 | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508176850 | San Juan Surgical, LLC | Radiology | 622 W Maple St Ste C, Farmington, NM 87401-6589 | 2010-10-19 |
| 1477788644 | Rural Radiology Associates Taos | Radiology | 1397 Weimar Rd, Taos, NM 87571-6253 | 2009-05-18 |
| 1982627238 | William Schaeffer | Radiology | Unm Dept of Radiology Msc10 5530, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2006-07-26 |
| 1598756595 | Michael Allen Gooden | Radiology | 201 Cedar St Se Ste 800, Albuquerque, NM 87106-4912 | 2005-10-31 |
| 1770587115 | Edward Poon | Radiology | 3860 Masthead St Ne, Albuquerque, NM 87109-4479 | 2005-06-13 |
| 1932736907 | City Mobile Group, LLC | Radiology | 524 Richmond Dr Se, Albuquerque, NM 87106-2328 | 2020-03-26 |
| 1811341662 | Pain Consultants & Intervention PC | Radiology | 3860 Masthead St Ne, Albuquerque, NM 87109-4479 | 2016-04-19 |
| 1174911093 | New Mexico Center for Minimally Invasive Therapies | Radiology | 4901 Lang Ave Ne, Suite 202, Albuquerque, NM 87109-4495 | 2014-12-30 |
| 1487997243 | Emily Rose Ochmanek | Radiology | Msc 10 5530, 1 University of New Mexico, Albuquerque, NM 87131-0001 | 2013-03-30 |
| 1902168578 | Thaddeus Fu-cheng Sze | Radiology | 1640 Hospital Dr, Santa Fe, NM 87505 | 2012-06-11 |
| 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.