| Bloom New Mexico Llc | |
|
2930 E Main St Farmington NM 87402-7624 | |
| (505) 326-6000 | |
| Not Available |
| Full Name | Bloom New Mexico Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2930 E Main St, Farmington, New Mexico |
| Authorized Official Name and Position | Spencer Smith (CEO) |
| Authorized Official Contact | 9705651919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloom New Mexico Llc 50 Henry St Cortez CO 81321-3012 Ph: () - | Bloom New Mexico Llc 2930 E Main St Farmington NM 87402-7624 Ph: (505) 326-6000 |
| NPI Number | 1750942207 |
|---|---|
| Provider Enumeration Date | 06/25/2019 |
| Last Update Date | 05/06/2020 |
| Medicare PECOS PAC ID | 8729417266 |
|---|---|
| Medicare Enrollment ID | O20200403000508 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750942207 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | April Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316212566 PECOS PAC ID: 9739339490 Enrollment ID: I20141224000083 |
| Provider Name | Vitina M Cosse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790032787 PECOS PAC ID: 1850699117 Enrollment ID: I20161122002146 |
| Provider Name | Kelsey Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801441647 PECOS PAC ID: 1759717952 Enrollment ID: I20200206002386 |
| Provider Name | Murry Sturkie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700825122 PECOS PAC ID: 9234197997 Enrollment ID: I20200403000615 |
| Provider Name | Jesse Alexander Keele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225661556 PECOS PAC ID: 8224467766 Enrollment ID: I20200521000523 |
| Provider Name | Erin Tinker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003477969 PECOS PAC ID: 0648691055 Enrollment ID: I20200610001438 |
| Provider Name | Ashley Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538707666 PECOS PAC ID: 6507292679 Enrollment ID: I20200624001529 |
| Provider Name | Susan Staples |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508380478 PECOS PAC ID: 2264706860 Enrollment ID: I20200701000585 |
| Provider Name | Crystal Nicole Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891260220 PECOS PAC ID: 3678814944 Enrollment ID: I20201125000811 |
| Provider Name | Douglas Accountius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730625047 PECOS PAC ID: 2062796451 Enrollment ID: I20201211000408 |
| Provider Name | Genevieve Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437741238 PECOS PAC ID: 8628484995 Enrollment ID: I20210311000206 |
| Provider Name | Michelle Rhonehouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184212318 PECOS PAC ID: 6204239262 Enrollment ID: I20210728001680 |
| Provider Name | Lori B Golzar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194468199 PECOS PAC ID: 1254710650 Enrollment ID: I20220615000624 |
| Provider Name | Justin Hamaker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396903365 PECOS PAC ID: 1850431370 Enrollment ID: I20230524003656 |
| Provider Name | Sean Roche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679001036 PECOS PAC ID: 8820361355 Enrollment ID: I20230728003154 |
| Provider Name | Anne Heckenbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427684216 PECOS PAC ID: 6901236421 Enrollment ID: I20230822001922 |
| Provider Name | Anysha Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497523963 PECOS PAC ID: 5092165613 Enrollment ID: I20231222001254 |
| Provider Name | Cynthia Oberholtzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770037251 PECOS PAC ID: 9335437144 Enrollment ID: I20250311003267 |
Chevannes Clinic Solutions, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 817 W Broadway Ste A, Farmington, NM 87401 Phone: 505-258-4867 Fax: 505-398-8748 | |
Presbyterian Medical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 W Broadway, Farmington, NM 87401 Phone: 505-327-4796 | |
Marie Rousseau Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 804 E Navajo St, Farmington, NM 87401 Phone: 505-327-5336 Fax: 505-326-9120 | |
Presbyterian Medical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 744 W Animas St, Farmington, NM 87401 Phone: 505-327-4796 Fax: 505-325-9113 | |
Advanced Gastroenterology Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4801 N Butler Ave, Suite 13102, Farmington, NM 87401 Phone: 505-436-2906 Fax: 505-436-2197 | |
Southwest Health Care Professionals Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1601 E 20th St, Farmington, NM 87401 Phone: 505-564-3628 Fax: 505-325-9228 | |
San Juan Regional Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 S. Schwartz Ave, Suite 201, Farmington, NM 87401 Phone: 505-609-6730 Fax: 505-609-6749 |