| Pinon Family Practice Pc | |
|
2300 E 30th St Bldg C-2 Farmington NM 87401-8990 | |
| (505) 324-1000 | |
| (505) 324-1199 |
| Full Name | Pinon Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2300 E 30th St, Farmington, New Mexico |
| Authorized Official Name and Position | Adana Mohler (CLINIC MANAGER) |
| Authorized Official Contact | 5053241000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinon Family Practice Pc 2300 E 30th St Bldg C-2 Farmington NM 87401-8990 Ph: (505) 324-1000 | Pinon Family Practice Pc 2300 E 30th St Bldg C-2 Farmington NM 87401-8990 Ph: (505) 324-1000 |
| NPI Number | 1598879652 |
|---|---|
| Provider Enumeration Date | 08/18/2006 |
| Last Update Date | 06/26/2023 |
| Medicare PECOS PAC ID | 1658399936 |
|---|---|
| Medicare Enrollment ID | O20051104000424 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598879652 | NPI | - | NPPES |
| Z7265 | Medicaid | NM | |
| 32D0943693 | Other | CLIA NUMBER | |
| CG6367 | Other | RAILROAD RETIRE CLINIC ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Annette L Randlemon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366468159 PECOS PAC ID: 8123090693 Enrollment ID: I20040806000543 |
| Provider Name | Holly P Abernethy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801836523 PECOS PAC ID: 2860407921 Enrollment ID: I20080709000471 |
| Provider Name | R Stephen Rankin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265527642 PECOS PAC ID: 1254484959 Enrollment ID: I20090728000626 |
| Provider Name | Sean Faherty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174501191 PECOS PAC ID: 5193858850 Enrollment ID: I20100802000274 |
| Provider Name | Ronald Bliss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912985946 PECOS PAC ID: 0547393860 Enrollment ID: I20100805001095 |
| Provider Name | David B Homer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295738656 PECOS PAC ID: 0143283937 Enrollment ID: I20160907002378 |
| Provider Name | Anthony V Aspesi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902210560 PECOS PAC ID: 4587889811 Enrollment ID: I20170804001225 |
| Provider Name | Heidi Jo Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821565243 PECOS PAC ID: 6406191089 Enrollment ID: I20181231001562 |
| Provider Name | William Curtis Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932557154 PECOS PAC ID: 0345534087 Enrollment ID: I20200904000779 |
| Provider Name | Megan Jaylyn Velasquez-baca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710580865 PECOS PAC ID: 8123436250 Enrollment ID: I20210409000796 |
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