PLACITAS MOUNTAIN MEDICAL, INC. (NPI# 1811424674) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811424674 |
| Entity Type | Organization |
| Organization Name | PLACITAS MOUNTAIN MEDICAL, INC. |
| Practice Address |
12127b Hwy 14 N Ste 5 Cedar Crest NM 87008-9499 |
| Practice Telephone | 5052815180 |
| Practice Fax Number | 5052815320 |
| Mailing Telephone | 5052815180 |
| Mailing Fax Number | 5052815320 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |
| Authorized Official Name | JAMES MARC BEVERLY (OWNER) |
| Authorized Official Telephone | 5052815180 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
12127B HWY 14 N STE 5 |
| City | CEDAR CREST |
| State | NM |
| Zip Code | 87008-9499 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770554149 | Roger Wesley Gildersleeve | Family Medicine | 12127b Hwy 14 N Ste 5, Cedar Crest, NM 87008-9499 | 2006-02-01 |
| 1083212195 | Amanda Torgerson | Registered Nurse | 12127b Hwy 14 N Ste 5, Cedar Crest, NM 87008-9557 | 2020-10-12 |
| 1447770698 | Shawn M Mcgee | Nurse Practitioner | 12127b Hwy 14 N Ste 5, Cedar Crest, NM 87008-9499 | 2017-06-20 |
| 1851828784 | Lauren Montano | Physician Assistant | 12127b Hwy 14 N Ste 5, Cedar Crest, NM 87008-9499 | 2017-05-23 |
| 1275542896 | Linda Sue Agnes | Nurse Practitioner | 12127b Hwy 14 N Ste 5, Cedar Crest, NM 87008-9461 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861090342 | Rio Grande Emdr Therapy, LLC | Community/Behavioral Health | 6 Sierra Vista Drive, Cedar Crest, NM 87008 | 2020-10-15 |
| 1487973145 | Phoenix Helm Simpson | Marriage & Family Therapist | 10 Haven Dr., Cedar Crest, NM 87008 | 2010-05-20 |
| 1548404825 | Amir H. Manoutchehri M.d. PC | Clinic/Center | 12125 State Highway 14 N., Cedar Crest, NM 87008 | 2009-04-30 |
| 1649412321 | Justin Andrew Kan | Emergency Medicine | 50 Calyx Ln, Cedar Crest, NM 87008 | 2009-03-27 |
| 1316184831 | Monique Y Keulen-nolet | Nurse Practitioner | 12127b North Highway 14, Suite #5, Cedar Crest, NM 87008 | 2009-01-21 |
| 1023141215 | Jana R. Covell | Physical Therapist | 12127 B3 N. Hwy 14, Cedar Crest, NM 87008 | 2007-03-14 |
| 1124156815 | Villa Santa Maria | Residential Treatment Facility, Emotionally Disturbed Children | 19 Cirquela Rd, Cedar Crest, NM 87008 | 2007-03-02 |
| 1083740971 | Amy Beth Marie Miller | Physical Therapist | 12127 B-3 North Highway 14, Cedar Crest, NM 87008 | 2007-02-26 |
| 1215019237 | Cedar Crest Vision LLC | Optometrist | 12220 North Highway 14, Suite 3, Cedar Crest, NM 87008 | 2006-10-19 |
| 1972519759 | Orrin Kent Mcleod | Family Medicine | 12127b N Hwy 14, Suite 5, Cedar Crest, NM 87008 | 2006-07-31 |
| Find all providers in zip 87008 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023420312 | Lisa Marie Stolarczyk Md Phd | Family Medicine | 8 Alicia Road, Cedar Crest, NM 87008-9450 | 2014-05-21 |
| 1972519759 | Orrin Kent Mcleod | Family Medicine | 12127b N Hwy 14, Suite 5, Cedar Crest, NM 87008 | 2006-07-31 |
| 1770554149 | Roger Wesley Gildersleeve | Family Medicine | 12127b Hwy 14 N Ste 5, Cedar Crest, NM 87008-9499 | 2006-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001024 | Laguna Healthcare Corp | Family Medicine | 6 Basswood Rd, Paraje, NM 87007 | 2020-10-20 |
| 1063027761 | Compassion Care Clinic PC | Family Medicine | 600 Hwy 195, Ste A, Elephant Butte, NM 87935 | 2020-09-10 |
| 1063027696 | Comprehensive Gastrostomy Tube Cares, LLC | Family Medicine | 8100 Wyoming Blvd Ne Ste M4-701, Albuquerque, NM 87113-1946 | 2020-09-10 |
| 1700498748 | Sandia View Family Medicine, PC | Family Medicine | 4200 Meadowlark Ln Se Ste 2, Rio Rancho, NM 87124-1050 | 2020-08-20 |
| 1740898428 | Dr. Maggie Wilson, PC | Family Medicine | 717 Encino Pl Ne Ste 5, Albuquerque, NM 87102-2624 | 2020-07-17 |
| 1861028102 | Lindsay Sue Cerrone | Family Medicine | 6 Kalma Ln, Edgewood, NM 87015-9593 | 2020-03-18 |
| 1053947408 | Optimal Wellness Journey | Family Medicine | 3231 Caminito San Lucas, Santa Fe, NM 87507-0443 | 2020-03-18 |
| 1831734813 | Leandra Lee Medina | Family Medicine | 7050 Barstow St Ne Ste B, Albuquerque, NM 87111-1056 | 2019-11-13 |
| 1053952473 | Healthnm, LLC | Family Medicine | 3612 Plano Vista Rd Ne, Rio Rancho, NM 87124-4182 | 2019-10-07 |
| 1497301824 | Gila Regional Medical Center | Family Medicine | 901 S. Gold Avenue, Deming, NM 88030 | 2019-08-12 |
| Find all providers with the same taxonomy | ||||
| City | CEDAR CREST |
| Zip Code | 87008 |
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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.