KEWA PUEBLO HEALTH CORPORATION (NPI# 1902183155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902183155 |
| Entity Type | Organization |
| Organization Name | KEWA PUEBLO HEALTH CORPORATION |
| Other Organization Name | SANTO DOMINGO HEALTH CENTER |
| Practice Address |
85 W Highway 22 Santo Domingo NM 87052-0340 |
| Mailing Address |
Po Box 559 Santo Domingo Pueblo NM 87052-0559 |
| Practice Telephone | 5054653060 |
| Practice Fax Number | 5054651191 |
| Mailing Telephone | 5054653060 |
| Mailing Fax Number | 5054651191 |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2011-11-15 |
| Authorized Official Name | VANESSA DIANA VIGIL (BUSINESS OFFICE MANAGER) |
| Authorized Official Telephone | 5054653060 |
| Is Organization Subpart | Y |
| Parent Organization Name | KEWA PUEBLO HEALTH CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Santo Domingo Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467739888 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo Pueblo, NM 87052-0559 | 2011-11-14 |
| 1336659077 | Kewa Pueblo Health Corporation | Community/Behavioral Health | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2017-10-09 |
| 1679842983 | Kewa Pueblo Health Corporation | Non-emergency Medical Transport (VAN) | 85 W Highway 22, Santo Domingo, NM 87052 | 2011-12-16 |
| 1811274061 | Kewa Pueblo Health Corporation | Clinical Medical Laboratory | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1194002345 | Kewa Pueblo Health Corporation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1003193251 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1558648709 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1467739615 | Kewa Pueblo Health Corporation | Optometrist | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| Street Address |
85 W HIGHWAY 22 |
| City | SANTO DOMINGO |
| State | NM |
| Zip Code | 87052-0340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679842983 | Kewa Pueblo Health Corporation | Non-emergency Medical Transport (VAN) | 85 W Highway 22, Santo Domingo, NM 87052 | 2011-12-16 |
| 1811274061 | Kewa Pueblo Health Corporation | Clinical Medical Laboratory | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1194002345 | Kewa Pueblo Health Corporation | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1003193251 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1558648709 | Kewa Pueblo Health Corporation | Clinic/Center | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| 1467739615 | Kewa Pueblo Health Corporation | Optometrist | 85 W Highway 22, Santo Domingo, NM 87052-0340 | 2011-11-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902353972 | Karin Luzzi | Registered Nurse | 100 Highway 22 W, Santo Domingo, NM 87052 | 2016-09-07 |
| 1043676273 | Kyle Maestas | Physician Assistant | 85 West Hwy 22, Santo Domingo, NM 87052 | 2016-01-04 |
| 1639579352 | Cynthia Brooks | Registered Nurse | 85 West Highway 22 Santo Domingo Health Center, Santo Domingo, NM 87052 | 2014-08-29 |
| 1720335219 | Samantha Nicole Torres | Pharmacist | 85 W Hwy 22, Santo Domingo, NM 87052 | 2012-08-14 |
| 1780835504 | Roger L Leonard | Clinic/Center | #85 West Hwy 22, Santo Domingo, NM 87052 | 2008-10-10 |
| 1679766489 | Santo Domingo Tribe | Ambulance | #1 Tesuque St., Ems Headquarters, Santo Domingo Pueblo, NM 87052 | 2007-08-24 |
| 1326165994 | Santa Domingo Ihs Pharmacy | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | 340 San Ildefonso St, Santa Domingo, NM 87052 | 2007-03-26 |
| 1467509612 | Andrea Heeter | Specialist/Technologist | Santo Domingo Health Center, 85 Hwy 22, Santo Domingo, NM 87052 | 2007-01-03 |
| 1164531950 | Jonathan Neil Trujillo | Pharmacist | 85 West Highway 22, Santo Domingo Health Center, Santo Domingo, NM 87052 | 2006-08-29 |
| 1053920520 | John Patirck Pagett | Registered Nurse | 85 West Highway 22, Santo Domingo Pueblo, NM 87052 | 2020-07-30 |
| Find all providers in zip 87052 | ||||
| Taxonomy Code | 261QH0700X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Hearing and Speech |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, prescriptive, and therapy services related to congenital and acquired conditions and diseases that affect hearing capacity and speech ability. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528682945 | New Mexico Hearing Aid & Tinnitus Center LLC | Clinic/Center | 5553 Lilac Pl Ne, Rio Rancho, NM 87144-5804 | 2020-06-01 |
| 1790333532 | Exclusive Hearing Center LLC | Clinic/Center | 1161 Mall Dr Ste D, Las Cruces, NM 88011-8193 | 2019-08-26 |
| 1609345545 | Northland Hearing Center, Inc. | Clinic/Center | 107 S Second St, Gallup, NM 87301-6219 | 2018-11-21 |
| 1417430406 | Lazy River Therapy Services, LLC | Clinic/Center | 3 Road 3660, Aztec, NM 87410-9020 | 2018-09-14 |
| 1003338732 | Silver Tongue Speech & Voice, LLC | Clinic/Center | 3001 Northridge Dr Ste C, Farmington, NM 87401 | 2017-07-14 |
| 1831588052 | Land of Enchantment Audiology LLC | Clinic/Center | 264 S Camino Del Pueblo, Building B, Bernalillo, NM 87004-6070 | 2015-01-12 |
| 1811233588 | Bilingual Interventions, LLC | Clinic/Center | 3805 Atrisco Dr Nw, Suite B, Albuquerque, NM 87120-4980 | 2012-12-27 |
| 1629533641 | Zia Hearing Center, LLC | Clinic/Center | 4001 N Butler Ave Ste 5101, Farmington, NM 87401-2392 | 2019-02-04 |
| 1619482064 | Sunshine Kids Therapy, LLC | Clinic/Center | 325 S Main St Ste A, Belen, NM 87002-3503 | 2017-12-07 |
| 1780043083 | Speech & Language A To Z, LLC | Clinic/Center | 6501 Wyoming Blvd Ne, Building C, Suite 115, Albuquerque, NM 87109-3932 | 2016-02-15 |
| Find all providers with the same taxonomy | ||||
| City | SANTO DOMINGO |
| Zip Code | 87052 |
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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.