| Clayton Health Systems Inc | |
|
314 N 3rd Ave Clayton NM 88415-3302 | |
| (505) 374-2273 | |
| (505) 374-0903 |
| Full Name | Clayton Health Systems Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 314 N 3rd Ave, Clayton, New Mexico |
| Authorized Official Name and Position | Jill Reynolds (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5052261800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clayton Health Systems Inc Po Box 489 Clayton NM 88415-0489 Ph: (505) 374-2585 | Clayton Health Systems Inc 314 N 3rd Ave Clayton NM 88415-3302 Ph: (505) 374-2273 |
| NPI Number | 1285715243 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 03/02/2018 |
| Medicare PECOS PAC ID | 0941195895 |
|---|---|
| Medicare Enrollment ID | O20040219000112 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285715243 | NPI | - | NPPES |
| 201040774 | Other | NM | PRESBYTERIAN CLINIC |
| K5719 | Medicaid | NM | |
| NM009F48 | Other | NM | BC CLINIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QC0050X | Clinic/center - Critical Access Hospital | 3060 (New Mexico) | Primary |
| Provider Name | Eric J Goldblatt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407927502 PECOS PAC ID: 1355230905 Enrollment ID: I20080528000428 |
| Provider Name | Mary Lou Guillot |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326023201 PECOS PAC ID: 2567457328 Enrollment ID: I20080716000754 |
| Provider Name | Jessie Jean Fluhman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518005354 PECOS PAC ID: 2264506948 Enrollment ID: I20080731000290 |
| Provider Name | Robert M Khanlian |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235352691 PECOS PAC ID: 3375631385 Enrollment ID: I20080926000442 |
| Provider Name | Mark E Van Wormer |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1013919034 PECOS PAC ID: 4183785041 Enrollment ID: I20081210000476 |
| Provider Name | Aiden M Orourke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164484002 PECOS PAC ID: 6002962206 Enrollment ID: I20140521000305 |
| Provider Name | Jamie Armijo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497276521 PECOS PAC ID: 5395017230 Enrollment ID: I20170828000892 |
| Provider Name | Terry Dean Weaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528063997 PECOS PAC ID: 2264428655 Enrollment ID: I20180618000528 |
| Provider Name | Paul Wheeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952540403 PECOS PAC ID: 8820281652 Enrollment ID: I20191217002102 |
Union County Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 314 N. 3rd Ave, Clayton, NM 88415 Phone: 575-374-8313 Fax: 575-374-2064 | |
Union County Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 314 N 3rd Ave, Clayton, NM 88415 Phone: 575-374-2273 Fax: 575-374-0903 |