| Mcleod Medical Centers Of Nm, Inc. | |
|
12127b Hwy 14 N Ste 5 Cedar Crest NM 87008-9499 | |
| (505) 281-5180 | |
| (505) 281-5320 |
| Full Name | Mcleod Medical Centers Of Nm, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 12127b Hwy 14 N Ste 5, Cedar Crest, New Mexico |
| Authorized Official Name and Position | Christina G. Marrufo (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 5059166544 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcleod Medical Centers Of Nm, Inc. 12127b Hwy 14 N Ste 5 Cedar Crest NM 87008-9499 Ph: (505) 281-5180 | Mcleod Medical Centers Of Nm, Inc. 12127b Hwy 14 N Ste 5 Cedar Crest NM 87008-9499 Ph: (505) 281-5180 |
| NPI Number | 1700393782 |
|---|---|
| Provider Enumeration Date | 12/29/2017 |
| Last Update Date | 06/05/2024 |
| Medicare PECOS PAC ID | 5092075531 |
|---|---|
| Medicare Enrollment ID | O20180201001863 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700393782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Timothy J Grenemyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588699391 PECOS PAC ID: 6709788300 Enrollment ID: I20040123000665 |
| Provider Name | Deanna M Suggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295726206 PECOS PAC ID: 8022088434 Enrollment ID: I20040730000968 |
| Provider Name | Francis K Torres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336233725 PECOS PAC ID: 3173589967 Enrollment ID: I20041203000201 |
| Provider Name | Edward H Taliaferro |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740252519 PECOS PAC ID: 2163460791 Enrollment ID: I20050610000424 |
| Provider Name | Connie J Ponce |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942359864 PECOS PAC ID: 1759325145 Enrollment ID: I20050815000683 |
| Provider Name | John R Stuart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235195439 PECOS PAC ID: 9739273863 Enrollment ID: I20070920000546 |
| Provider Name | Maria A Tapia-sauerman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609960095 PECOS PAC ID: 3779610019 Enrollment ID: I20100419000681 |
| Provider Name | Gina N. Rubidoux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184013948 PECOS PAC ID: 5698093151 Enrollment ID: I20150413001176 |
| Provider Name | Kathy Marie Wolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356899355 PECOS PAC ID: 1557649084 Enrollment ID: I20161103000317 |
| Provider Name | Douglas I Ludington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982113445 PECOS PAC ID: 8426324773 Enrollment ID: I20171101000736 |
| Provider Name | Elyssa Ackerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356752257 PECOS PAC ID: 9739304155 Enrollment ID: I20180226000668 |
| Provider Name | John Mark Pope |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497312599 PECOS PAC ID: 0446586572 Enrollment ID: I20190729000704 |
| Provider Name | Lisa M Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649642901 PECOS PAC ID: 8527368109 Enrollment ID: I20191004000796 |
| Provider Name | Jennifer Jeanne Winters Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760006225 PECOS PAC ID: 9931527033 Enrollment ID: I20200921002990 |
| Provider Name | Caley Nicole Denevers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093332587 PECOS PAC ID: 8729407382 Enrollment ID: I20210201001569 |
| Provider Name | Shantal Aime Giron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508531435 PECOS PAC ID: 2466858956 Enrollment ID: I20210908003859 |
| Provider Name | Yourah Hwang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992477756 PECOS PAC ID: 0840688818 Enrollment ID: I20211025000255 |
| Provider Name | Kwanza Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932566742 PECOS PAC ID: 1951699412 Enrollment ID: I20220105000351 |
| Provider Name | Christina Andre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598034936 PECOS PAC ID: 0042609711 Enrollment ID: I20220214001849 |
| Provider Name | Dannial Rene Coston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235881145 PECOS PAC ID: 2961899901 Enrollment ID: I20220421002353 |
| Provider Name | Marsha Lester-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275202889 PECOS PAC ID: 9830579416 Enrollment ID: I20220629003077 |
| Provider Name | Ashley Gambling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417693672 PECOS PAC ID: 8325420177 Enrollment ID: I20220727000628 |
| Provider Name | Melany Gadberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437898475 PECOS PAC ID: 6204218738 Enrollment ID: I20220801001154 |
| Provider Name | Jessica Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831822980 PECOS PAC ID: 8022492917 Enrollment ID: I20220825003708 |
| Provider Name | Cheryl Birmingham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679958359 PECOS PAC ID: 0749664001 Enrollment ID: I20220906000829 |
| Provider Name | Shelby M Manno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215655287 PECOS PAC ID: 7416333091 Enrollment ID: I20221005001578 |
| Provider Name | Shawna Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043553472 PECOS PAC ID: 7810130846 Enrollment ID: I20230407000143 |
| Provider Name | Alyssa B Mirabal |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1043773005 PECOS PAC ID: 9234466228 Enrollment ID: I20230508002225 |
| Provider Name | Rachel Beth Vanwettering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548965676 PECOS PAC ID: 0547626756 Enrollment ID: I20230512002554 |
| Provider Name | Heather Marie Pink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700349834 PECOS PAC ID: 3476908815 Enrollment ID: I20231004004090 |
| Provider Name | Kristina Agranat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043726904 PECOS PAC ID: 3870856446 Enrollment ID: I20231214002837 |
| Provider Name | Bonnie Jean Evans |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366863706 PECOS PAC ID: 1355792045 Enrollment ID: I20240106000753 |
| Provider Name | Vanessa Brimigion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467820480 PECOS PAC ID: 5092005066 Enrollment ID: I20240214001392 |
| Provider Name | Laura Cosimi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336793850 PECOS PAC ID: 4688012131 Enrollment ID: I20240403003108 |
| Provider Name | Arielle Nicole Feggins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1578911004 PECOS PAC ID: 5991241291 Enrollment ID: I20240723002679 |
| Provider Name | Angelo Giovanni Taraddei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710738398 PECOS PAC ID: 1759822216 Enrollment ID: I20240924002459 |
| Provider Name | Rachel Renee Valerio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720810120 PECOS PAC ID: 0345774329 Enrollment ID: I20241113002887 |
| Provider Name | Amanda Marie Painter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013265644 PECOS PAC ID: 5597292847 Enrollment ID: I20241226002707 |
| Provider Name | Larissa Baldonado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730691742 PECOS PAC ID: 2365972734 Enrollment ID: I20250214000410 |
Lisa Marie Stolarczyk Md Phd Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8 Alicia Road, Cedar Crest, NM 87008 Phone: 505-270-6499 | |
Turquoise Family Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Canyon Ln, Cedar Crest, NM 87008 Phone: 575-621-0144 | |
Placitas Mountain Medical, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12127b Hwy 14 N Ste 5, Cedar Crest, NM 87008 Phone: 505-281-5180 Fax: 505-281-5320 |