EL CENTRO FAMILY HEALTH (NPI# 1912324724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912324724 |
| Entity Type | Organization |
| Organization Name | EL CENTRO FAMILY HEALTH |
| Other Organization Name | EL CENTRO FAMILY HEALTH PSBHC |
| Practice Address |
14190 State Road 75 Penasco NM 87553 |
| Mailing Address |
538 N Paseo De Onate P.o. Box 158 Espanola NM 87532-2618 |
| Practice Telephone | 5755872623 |
| Practice Fax Number | 5755872317 |
| Mailing Telephone | 5057537218 |
| Mailing Fax Number | 5057535815 |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2014-11-21 |
| Authorized Official Name | MRS. LORE PEASE (CEO) |
| Authorized Official Telephone | 5057537218 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 03025365 | 05 | |
| NM | NPPES | 1780689034 | 01 |
| Other Name | Type Code |
|---|---|
| El Centro Family Health PSBHC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669930392 | El Centro Family Health | Clinic/Center | 1401 8th Street, Springer, NM 87747 | 2019-03-12 |
| 1316475403 | El Centro Family Health | Family Medicine | 475 Legion Dr., Las Vegas, NM 87701 | 2017-06-01 |
| 1902208234 | El Centro Family Health | Clinic/Center | 1236 5th St, Las Vegas, NM 87701-4337 | 2014-09-18 |
| 1538561964 | El Centro Family Health | Clinic/Center | 947 Old National Road, Las Vegas, NM 87701 | 2014-09-17 |
| 1457798712 | El Centro Family Health | Clinic/Center | 1260 Industrial Park Rd, Espanola, NM 87532-3503 | 2013-05-28 |
| 1164782462 | El Centro Family Health | Clinic/Center | 15136 St. Rd., Penasco, NM 87553-0000 | 2012-05-21 |
| 1821373812 | El Centro Family Health | Clinic/Center | 711 Bond St., Espanola, NM 87532-2729 | 2011-10-21 |
| 1013202969 | El Centro Family Health | Nurse Practitioner | 620 N. Coronado Street, Espanola, NM 87532-0158 | 2011-06-17 |
| 1467617837 | El Centro Family Health | Clinic/Center | County Road 75 House #60, Truchas, NM 87578-0346 | 2008-07-24 |
| 1760647457 | El Centro Family Health | Clinic/Center | 275 Nm 3, Ribera, NM 87560-0277 | 2008-07-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EL CENTRO FAMILY HEALTH | 538 N Paseo De Onate, Espanola, NM 87532-2618 |
| Street Address |
14190 STATE ROAD 75 |
| City | PENASCO |
| State | NM |
| Zip Code | 87553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366092645 | Shannon Monique Medina | Social Worker | 13 Old School Rd, Penasco, NM 87553 | 2019-09-18 |
| 1356825186 | Roberta Rodriguez | Dental Hygienist | 15136 St Hwy 75, Penasco, NM 87553 | 2018-09-18 |
| 1750796058 | Greta Carson | Counselor | 15 School Road, Penasco, NM 87553 | 2014-06-25 |
| 1972782472 | Erik Alexander Watson | Dentist | 15136 State Road 75, Penasco, NM 87553 | 2007-10-31 |
| 1871586248 | Lyn M. St. Louis | Dental Hygienist | House#013405 State Rd. 75 - Hcnnm Penasco Dental, Penasco, NM 87553 | 2005-08-31 |
| 1669840310 | Laura Mccutcheon | Physician Assistant | 15136 State Road 75, Penasco, NM 87553 | 2015-09-11 |
| 1366783771 | David N Gould | Physician Assistant | 15136 St. Rd. 75, El Centro Family Health Penasco Medical Clinic, Penasco, NM 87553 | 2013-03-11 |
| 1164782462 | El Centro Family Health | Clinic/Center | 15136 St. Rd., Penasco, NM 87553-0000 | 2012-05-21 |
| 1669521282 | Taos Health Systems Inc Holy Cross Hospital | Clinic/Center | #24 Highway 73, Penasco, NM 87553-0205 | 2007-01-10 |
| 1720071186 | Douglas A. North | Physician Assistant | 15136 St. Rd. 75, Penasco, NM 87553-0238 | 2005-08-31 |
| Find all providers in zip 87553 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790940716 | El Centro Family Health | Clinic/Center | State Road 75 #15136, Penasco, NM 87553-2627 | 2008-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265666 | Hidalgo Medical Services | Clinic/Center | 105 1/2 N East St., Santa Clara, NM 88026 | 2020-08-12 |
| 1902436702 | La Clinica De Familia, Incorporated | Clinic/Center | 510 E Lisa Dr Bldg 2, Chaparral, NM 88081-7809 | 2020-01-21 |
| 1114578671 | La Clinica De Familia, Inc. | Clinic/Center | 100 Shrode Rd, Anthony, NM 88021-7350 | 2019-09-26 |
| 1083262422 | Presbyterian Medical Services | Clinic/Center | 28 Panther Parkway, 63 North Highway, Pecos, NM 87552 | 2019-08-29 |
| 1669930392 | El Centro Family Health | Clinic/Center | 1401 8th Street, Springer, NM 87747 | 2019-03-12 |
| 1487119608 | Presbyterian Medical Services | Clinic/Center | 1 Salomon Griego Road, Veguita, NM 87062 | 2019-02-01 |
| 1417440777 | Las Clinicas Del Norte Incorporated | Clinic/Center | 1797b St. Rd 502, Santa Fe, NM 87506 | 2018-06-12 |
| 1467971986 | Hidalgo Medical Services | Clinic/Center | 3200 32nd St Bypass, Silver City, NM 88061 | 2017-09-15 |
| 1417472192 | Fnch Outpatient Services | Clinic/Center | 634 Manzano Street Ne, Albuquerque, NM 87110 | 2017-08-03 |
| 1689034662 | La Clinica De Familia, Inc. | Clinic/Center | 6301 Nm Highway 28, Anthony, NM 88021 | 2016-03-03 |
| Find all providers with the same taxonomy | ||||
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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.