Duke City Primary Care | |
1108 W Us Route 66 Moriarty NM 87035-1006 | |
(505) 832-4434 | |
(505) 832-5024 |
Full Name | Duke City Primary Care |
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Speciality | Family Medicine |
Location | 1108 W Us Route 66, Moriarty, New Mexico |
Authorized Official Name and Position | Theresa G. Romero (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 5052815180 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Duke City Primary Care 12127b Hwy 14 N Ste 5 Cedar Crest NM 87008-9499 Ph: (505) 281-5180 | Duke City Primary Care 1108 W Us Route 66 Moriarty NM 87035-1006 Ph: (505) 832-4434 |
NPI Number | 1700393782 |
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Provider Enumeration Date | 12/29/2017 |
Last Update Date | 06/16/2021 |
Medicare PECOS PAC ID | 5092075531 |
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Medicare Enrollment ID | O20180201001863 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700393782 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Orrin K Mcleod |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1972519759 PECOS PAC ID: 6103736079 Enrollment ID: I20031113000262 |
Provider Name | Timothy J Grenemyer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1588699391 PECOS PAC ID: 6709788300 Enrollment ID: I20040123000665 |
Provider Name | Deanna M Suggs |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1295726206 PECOS PAC ID: 8022088434 Enrollment ID: I20040730000968 |
Provider Name | Francis K Torres |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336233725 PECOS PAC ID: 3173589967 Enrollment ID: I20041203000201 |
Provider Name | Edward H Taliaferro |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1740252519 PECOS PAC ID: 2163460791 Enrollment ID: I20050610000424 |
Provider Name | Connie J Ponce |
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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 | Harry R Burger |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1477510543 PECOS PAC ID: 9335206176 Enrollment ID: I20090324000244 |
Provider Name | Naishadh A Mankad |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1598733859 PECOS PAC ID: 8224189436 Enrollment ID: I20090630000101 |
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 | Monique Keulen-nolet |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316184831 PECOS PAC ID: 9032243829 Enrollment ID: I20100816000671 |
Provider Name | Lynda Ann Green |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538141221 PECOS PAC ID: 1951210582 Enrollment ID: I20140623001706 |
Provider Name | Cesar A Salazar Soto |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1396154373 PECOS PAC ID: 6709108327 Enrollment ID: I20141209001439 |
Provider Name | Gina N. Evans |
---|---|
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 Ivan Ludington |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1982113445 PECOS PAC ID: 8426324773 Enrollment ID: I20171101000736 |
Provider Name | Fabian Alberto Rodriguez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174989115 PECOS PAC ID: 9739484924 Enrollment ID: I20171219000405 |
Provider Name | Elyssa Ackerman |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356752257 PECOS PAC ID: 9739304155 Enrollment ID: I20180226000668 |
Provider Name | Mai Ngoc Luu |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1306108402 PECOS PAC ID: 7618299066 Enrollment ID: I20180514002004 |
Provider Name | Sarah E Simmons |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1689160376 PECOS PAC ID: 0244589885 Enrollment ID: I20180815002602 |
Provider Name | Brandon I Ferguson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1457747917 PECOS PAC ID: 9032422811 Enrollment ID: I20180911002025 |
Provider Name | Jeannett Martinez |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1629543640 PECOS PAC ID: 8224373493 Enrollment ID: I20181215000353 |
Provider Name | John Mark Pope |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497312599 PECOS PAC ID: 0446586572 Enrollment ID: I20190729000704 |
Provider Name | Elizabeth Moran |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902468861 PECOS PAC ID: 7810224847 Enrollment ID: I20190813002494 |
Provider Name | Steven T Lackey |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649222910 PECOS PAC ID: 6800817776 Enrollment ID: I20190829000440 |
Provider Name | Maria Pasillas |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609437334 PECOS PAC ID: 8729317870 Enrollment ID: I20190916000391 |
Provider Name | Lisa M Price |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1649642901 PECOS PAC ID: 8527368109 Enrollment ID: I20191004000796 |
Provider Name | Branyan Garcia |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1063070241 PECOS PAC ID: 0446586770 Enrollment ID: I20200402002796 |
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 | Amanda Torgerson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1083212195 PECOS PAC ID: 4082026141 Enrollment ID: I20201214001595 |
Provider Name | Christie D Domme |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376142422 PECOS PAC ID: 5496168890 Enrollment ID: I20210104000476 |
Provider Name | Caley Nicole Denevers |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093332587 PECOS PAC ID: 8729407382 Enrollment ID: I20210201001569 |
Provider Name | Storm A Dorrough |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1609363811 PECOS PAC ID: 9739437179 Enrollment ID: I20210805000575 |
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 | Noah J White |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1609465202 PECOS PAC ID: 9436538345 Enrollment ID: I20220623002650 |
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 | Alexandria L Giannini |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1811470958 PECOS PAC ID: 9133468390 Enrollment ID: I20230316002709 |
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 | Stephanie Marie Neufeld |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1336603356 PECOS PAC ID: 3779949342 Enrollment ID: I20230524001337 |
Provider Name | Jennifer Marie Otero |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1881387736 PECOS PAC ID: 7911351325 Enrollment ID: I20231003002531 |
Provider Name | Heather Marie Pink |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1700349834 PECOS PAC ID: 3476908815 Enrollment ID: I20231004004090 |
Provider Name | Darian Siddhartha Dhawan |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1811493018 PECOS PAC ID: 6901255967 Enrollment ID: I20231215001662 |
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 |
New Mexico Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1108 W Us Route 66, Moriarty, NM 87035 Phone: 505-832-4434 Fax: 505-832-5024 |