| Island Medical Hospitalist Lea Llc | |
|
5419 N Lovington Hwy Hobbs NM 88240-9100 | |
| (844) 474-4019 | |
| Not Available |
| Full Name | Island Medical Hospitalist Lea Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5419 N Lovington Hwy, Hobbs, New Mexico |
| Authorized Official Name and Position | Melissa Reese (PROVIDER ENROLLMENT OFFICER) |
| Authorized Official Contact | 8556870618 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Medical Hospitalist Lea Llc 4535 Dressler Rd Nw Canton OH 44718-2545 Ph: (330) 994-4409 | Island Medical Hospitalist Lea Llc 5419 N Lovington Hwy Hobbs NM 88240-9100 Ph: (844) 474-4019 |
| NPI Number | 1215307194 |
|---|---|
| Provider Enumeration Date | 10/05/2015 |
| Last Update Date | 02/24/2023 |
| Medicare PECOS PAC ID | 8527368943 |
|---|---|
| Medicare Enrollment ID | O20151207002531 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215307194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | William A Gaspar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497739015 PECOS PAC ID: 0244221331 Enrollment ID: I20081103000125 |
| Provider Name | Fahad Inam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073734166 PECOS PAC ID: 0840346235 Enrollment ID: I20090928000205 |
| Provider Name | Morris Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043546351 PECOS PAC ID: 6608902184 Enrollment ID: I20100818001341 |
| Provider Name | Sara L Campbell |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1134434525 PECOS PAC ID: 4587842406 Enrollment ID: I20110624000022 |
| Provider Name | Faith Solomon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508157975 PECOS PAC ID: 2264605781 Enrollment ID: I20111028000375 |
| Provider Name | Vidya M Raj Krishnamurthy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528184538 PECOS PAC ID: 2961653647 Enrollment ID: I20121105000569 |
| Provider Name | Staci West |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326383589 PECOS PAC ID: 6800049644 Enrollment ID: I20130104000051 |
| Provider Name | Benjamin Huneycutt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023050549 PECOS PAC ID: 4486626140 Enrollment ID: I20131230001533 |
| Provider Name | Ruben A Supan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619392883 PECOS PAC ID: 8426271131 Enrollment ID: I20140528000654 |
| Provider Name | Missy L Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568653525 PECOS PAC ID: 7618051277 Enrollment ID: I20140926000219 |
| Provider Name | David Agyapong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275821670 PECOS PAC ID: 2062631096 Enrollment ID: I20141030001129 |
| Provider Name | Segun Patrick Adeoye |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629418025 PECOS PAC ID: 3779717640 Enrollment ID: I20150203000859 |
| Provider Name | Clay H Schneiter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194928853 PECOS PAC ID: 1456445758 Enrollment ID: I20150324001924 |
| Provider Name | Lang M Chhour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538575667 PECOS PAC ID: 2668692237 Enrollment ID: I20150629001002 |
| Provider Name | Tahir Mahmood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508111089 PECOS PAC ID: 1658685482 Enrollment ID: I20150806011200 |
| Provider Name | David Hayes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760555882 PECOS PAC ID: 3072506922 Enrollment ID: I20151228000060 |
| Provider Name | Olusola Kolade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639497779 PECOS PAC ID: 0648592147 Enrollment ID: I20151228000122 |
| Provider Name | Milton Randall Dalbow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972561314 PECOS PAC ID: 7012070683 Enrollment ID: I20160407000061 |
| Provider Name | Francisco Cardona Rivera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417121989 PECOS PAC ID: 7517133374 Enrollment ID: I20160427001893 |
| Provider Name | Kevin Nesh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407116858 PECOS PAC ID: 2163737453 Enrollment ID: I20160526002326 |
| Provider Name | Layhong Soth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366602294 PECOS PAC ID: 6800054859 Enrollment ID: I20160617001107 |
| Provider Name | Jose A Aguirre |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295785566 PECOS PAC ID: 9830121094 Enrollment ID: I20160713001241 |
| Provider Name | Camille Ann Doan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639460900 PECOS PAC ID: 7214159813 Enrollment ID: I20161206002238 |
| Provider Name | Kelly Lawrence |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396041679 PECOS PAC ID: 4082859459 Enrollment ID: I20170310000096 |
| Provider Name | Justin Oneese |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477693901 PECOS PAC ID: 2365755949 Enrollment ID: I20170324001008 |
| Provider Name | Kontasha Shamika Wise |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679850044 PECOS PAC ID: 5395906960 Enrollment ID: I20171206001432 |
| Provider Name | Frank R Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538619267 PECOS PAC ID: 1456633601 Enrollment ID: I20180530000226 |
| Provider Name | Richard Lapin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598784969 PECOS PAC ID: 1456322254 Enrollment ID: I20180703000555 |
| Provider Name | Ryan Victor Villegas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780029215 PECOS PAC ID: 2163790270 Enrollment ID: I20180814001369 |
| Provider Name | Vijayabhaskar R Kandula |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427067511 PECOS PAC ID: 9133186935 Enrollment ID: I20181001001999 |
| Provider Name | Sowmya Gowda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346365673 PECOS PAC ID: 8527126234 Enrollment ID: I20181024000304 |
| Provider Name | John Heathcote |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295117836 PECOS PAC ID: 4880947068 Enrollment ID: I20181106000621 |
| Provider Name | Prathima Ramaprasad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346521101 PECOS PAC ID: 9638315500 Enrollment ID: I20181116000501 |
| Provider Name | Vijaykumar Lingegowda |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205838844 PECOS PAC ID: 0749269173 Enrollment ID: I20181116002454 |
| Provider Name | Jorge Santibanez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568446672 PECOS PAC ID: 9739179847 Enrollment ID: I20190206002443 |
| Provider Name | Frederick R Stack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548256977 PECOS PAC ID: 9638149230 Enrollment ID: I20200511003250 |
| Provider Name | Derek Senior |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447632088 PECOS PAC ID: 0244589026 Enrollment ID: I20200825000401 |
Hobbs Family Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 W Lea St, Hobbs, NM 88240 Phone: 575-391-0270 Fax: 575-391-0271 | |
Supam Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5419 North Lovington Highway, Suite 7, Hobbs, NM 88240 Phone: 575-392-3903 Fax: 575-392-3911 | |
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La Victoria Health For All, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3830 N Grimes St, Suite G, Hobbs, NM 88240 Phone: 575-397-3362 Fax: 575-397-0293 | |
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