ROBERTA L. FENNIG DO PC (NPI# 1912259441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912259441 |
| Entity Type | Organization |
| Organization Name | ROBERTA L. FENNIG DO PC |
| Practice Address |
5305 Mcnutt Rd Suite H Santa Teresa NM 88008-9685 |
| Mailing Address |
Po Box 4 Santa Teresa NM 88008-0004 |
| Practice Telephone | 5755891770 |
| Practice Fax Number | 5755891799 |
| Mailing Telephone | 5755891770 |
| Mailing Fax Number | 5755891799 |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2012-10-08 |
| Authorized Official Name | DR. ROBERTA LEE FENNIG (PRESIDENT) |
| Authorized Official Telephone | 9154941237 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | A167712 | NM | Ambulatory Health Care Facilities |
| Street Address |
5305 MCNUTT RD SUITE H |
| City | SANTA TERESA |
| State | NM |
| Zip Code | 88008-9685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265758452 | At-home Personal Care Services LLC. | Home Health | 5305 Mcnutt Rd, Suite A, Santa Teresa, NM 88008-9653 | 2010-04-13 |
| 1356857692 | Carolina Rodriguez | Counselor | 5305 Mcnutt Rd, Santa Teresa, NM 88008-9685 | 2017-12-22 |
| 1245746577 | Valeria Macias | Counselor | 5305 Mcnutt Rd, Santa Teresa, NM 88008-9685 | 2017-12-22 |
| 1134660871 | Carolina Lara | Counselor | 5305 Mcnutt Rd, Santa Teresa, NM 88008-9685 | 2017-03-14 |
| 1033663984 | Amanecer Community Counseling Center | Community/Behavioral Health | 5305 Mcnutt Rd, Santa Teresa, NM 88008-9685 | 2016-08-09 |
| 1790238319 | Menochat | Clinic/Center | 5305 Mcnutt Rd, 204, Santa Teresa, NM 88008-9685 | 2016-07-31 |
| 1447639810 | Maria Lourdes Burciaga | Counselor | 5305 Mcnutt Rd, Santa Teresa, NM 88008-9685 | 2015-05-19 |
| 1891187134 | Norma Renteria | Counselor | 5305 Mcnutt Rd, Santa Teresa, NM 88008-9685 | 2015-02-24 |
| 1437557709 | Fernando Gomez | Counselor | 5305 Mcnutt Rd, Santa Teresa, NM 88008-9685 | 2014-12-18 |
| 1790100956 | Alex Babani | Counselor | 5305 Mcnutt Rd, Suite 201, Santa Teresa, NM 88008-9685 | 2014-02-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912507211 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 5690 Santa Teresita Drive, Suite A2, Room P1, Santa Teresa, NM 88008 | 2020-10-27 |
| 1891848131 | Direct Healthcare South Inc | Home Health | 101 Livingston Loop, Suite 5, Santa Teresa, NM 88008 | 2007-01-19 |
| 1912061235 | Rio Valle Behavioral Health Centre | Psychiatry & Neurology | 101 Livinston Loop, Bldg C Suite 3, Santa Teresa, NM 88008 | 2006-12-21 |
| 1679634562 | Robert L Nichols | Family Medicine | 1300 Country Club Road, Santa Teresa, NM 88008 | 2006-12-13 |
| 1881792950 | Leo J Raschbaum Mdpc | Clinic/Center | 5690 Santa Teresita, Building A, Suite 4, Santa Teresa, NM 88008 | 2006-09-20 |
| 1366410276 | Emilio T. Rivera | Anesthesiology | 5290 Mcnutt Rd, Ste 109, Santa Teresa, NM 88008 | 2006-03-08 |
| 1225486194 | Diane Rivera | Registered Nurse | 101 Airport Road, Santa Teresa, NM 88008 | 2016-06-01 |
| 1780080358 | Audriana Apodaca | Nurse Practitioner | 100 Airport Rd, Santa Teresa, NM 88008 | 2014-11-10 |
| 1447667001 | Noha Oushy Eissa | Dentist | 103 Livingston Loop Ste B3, Santa Teresa, NM 88008 | 2014-07-16 |
| 1871963017 | Oralia Quezada | Student in an Organized Health Care Education/Training Program | 103 Livingston Loop, Bldg B, Suite 4, Santa Teresa, NM 88008-1063 | 2015-09-30 |
| Find all providers in zip 88008 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346431400 | Total Therapy Solutions LLC | Clinic/Center | 1300 Country Club Rd Ste C, Santa Teresa, NM 88008-9449 | 2007-08-05 |
| 1144757063 | Santa Teresa Family Medical Center | Clinic/Center | 5055 Mcnutt Rd, Santa Teresa, NM 88008-9442 | 2017-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295350437 | Clinica Para Todos | Clinic/Center | 7345 Yorktown Ave Ne, Albuquerque, NM 87109-5070 | 2020-06-13 |
| 1649894544 | Hope Medical Services, LLC | Clinic/Center | 305 Faculty Ln, Corrales, NM 87048-8721 | 2020-06-05 |
| 1285260588 | Uptown Dermatology LLC | Clinic/Center | 8016 Constitution Pl Ne, Albuquerque, NM 87110-7628 | 2020-03-18 |
| 1194372789 | Las Clinicas Del Norte Incorporated | Clinic/Center | 1183 Diamond Dr Ste D, Los Alamos, NM 87544-2228 | 2019-08-20 |
| 1245798024 | Lovelace Health System, Inc. | Clinic/Center | 460 Saint Michaels Dr Ste 505, Santa Fe, NM 87505-7622 | 2019-03-11 |
| 1083188585 | Hearing and Vision Store | Clinic/Center | 8400 Menaul Blvd Ne Ste F, Albuquerque, NM 87112-2200 | 2019-01-17 |
| 1588136956 | Hope and Healing Counseling LLC | Clinic/Center | 5880 First St., Organ, NM 88052 | 2018-12-26 |
| 1811473978 | Presbyterian Medical Services | Clinic/Center | 282 Casa Blanca Rd, Casa Blanca, NM 87007 | 2018-07-12 |
| 1144733924 | Heights Family Wellness Center LLC | Clinic/Center | 5800 Mcleod Rd Ne Ste C, Albuquerque, NM 87109-2467 | 2017-11-14 |
| 1053850784 | Olive Tree Pharmacy, Co. | Clinic/Center | 1920 Westside Blvd Se Ste B, Rio Rancho, NM 87124-4893 | 2017-02-14 |
| Find all providers with the same taxonomy | ||||
| City | SANTA TERESA |
| Zip Code | 88008 |
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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.