| Roswell Clinic Corp | |
|
350 W Country Club Rd Ste 201 Roswell NM 88201-5205 | |
| (888) 801-5554 | |
| Not Available |
| Full Name | Roswell Clinic Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 350 W Country Club Rd, Roswell, New Mexico |
| Authorized Official Name and Position | Jennifer L Jackson (SENIOR DIRECTOR, ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Roswell Clinic Corp 4000 Meridian Blvd Franklin TN 37067-6325 Ph: (615) 465-7000 | Roswell Clinic Corp 350 W Country Club Rd Ste 201 Roswell NM 88201-5205 Ph: (888) 801-5554 |
| NPI Number | 1649267618 |
|---|---|
| Provider Enumeration Date | 10/04/2005 |
| Last Update Date | 01/25/2022 |
| Medicare PECOS PAC ID | 9436062759 |
|---|---|
| Medicare Enrollment ID | O20031111000799 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649267618 | NPI | - | NPPES |
| 60806516 | Medicaid | NM | |
| DD5451 | Other | NM | RR MEDICARE |
| DA5509 | Other | NM | RR MEDICARE |
| NPI AND TIN | Other | NM | BCBS |
| Provider Name | Truett Maddox |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356305536 PECOS PAC ID: 4385530898 Enrollment ID: I20040223000873 |
| Provider Name | Audrey Vega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659368256 PECOS PAC ID: 2961489406 Enrollment ID: I20040702000299 |
| Provider Name | Richard Pinon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265437305 PECOS PAC ID: 3870564370 Enrollment ID: I20040805001005 |
| Provider Name | Scott Mcmahon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528078938 PECOS PAC ID: 5496799140 Enrollment ID: I20051102000201 |
| Provider Name | David E Mansfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609852961 PECOS PAC ID: 2466473673 Enrollment ID: I20060104000833 |
| Provider Name | Jeffrey T Ash |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1235149196 PECOS PAC ID: 3971548017 Enrollment ID: I20060228000129 |
| Provider Name | Akbar Ali |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578558219 PECOS PAC ID: 5890728182 Enrollment ID: I20060421000031 |
| Provider Name | John Dirk Wassner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366410961 PECOS PAC ID: 7517977838 Enrollment ID: I20060509000613 |
| Provider Name | Tania D Pence |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649294125 PECOS PAC ID: 0941203723 Enrollment ID: I20060816000575 |
| Provider Name | James J Castle |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205880689 PECOS PAC ID: 1254338601 Enrollment ID: I20061027000482 |
| Provider Name | Virgle O Herrin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124009501 PECOS PAC ID: 9436253911 Enrollment ID: I20070323000165 |
| Provider Name | Paul R Whitwam |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912950122 PECOS PAC ID: 5092895821 Enrollment ID: I20080107000642 |
| Provider Name | Sebastian Lopez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730186362 PECOS PAC ID: 6608934815 Enrollment ID: I20081125000817 |
| Provider Name | Daniel Nazon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386676476 PECOS PAC ID: 7719968429 Enrollment ID: I20091028000382 |
| Provider Name | Ajoy Kumar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831238872 PECOS PAC ID: 1557409091 Enrollment ID: I20091103000685 |
| Provider Name | Lisa M Hobbs |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1285690560 PECOS PAC ID: 7113069626 Enrollment ID: I20100121000672 |
| Provider Name | Fundador L Adajar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013919232 PECOS PAC ID: 4789742735 Enrollment ID: I20100125000797 |
| Provider Name | Christopher Lynn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043419997 PECOS PAC ID: 0042309296 Enrollment ID: I20100426000016 |
| Provider Name | Kingsley C Okonkwo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982732178 PECOS PAC ID: 2860518578 Enrollment ID: I20100929001556 |
| Provider Name | Jan D Hobbs |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1225090046 PECOS PAC ID: 4688635758 Enrollment ID: I20110221000658 |
| Provider Name | Jay Bishop |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1407846850 PECOS PAC ID: 9436062320 Enrollment ID: I20110316000552 |
| Provider Name | Michael Nowak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558360131 PECOS PAC ID: 2264427384 Enrollment ID: I20110615000065 |
| Provider Name | Jana R Mullen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043291115 PECOS PAC ID: 8022134329 Enrollment ID: I20110616000625 |
| Provider Name | Jane E Mcmillan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831109156 PECOS PAC ID: 3274616669 Enrollment ID: I20110722000507 |
| Provider Name | Chandra Sekhar Yangalasetty |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740449396 PECOS PAC ID: 6608922075 Enrollment ID: I20111028000450 |
| Provider Name | Cindy D Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528386034 PECOS PAC ID: 1456482496 Enrollment ID: I20120215000945 |
| Provider Name | Najeeb Ansari |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992816227 PECOS PAC ID: 0547427270 Enrollment ID: I20130130000021 |
| Provider Name | Zafar Parvez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750392361 PECOS PAC ID: 8921997677 Enrollment ID: I20130205000052 |
| Provider Name | Charles H Haddad |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346220456 PECOS PAC ID: 9638110117 Enrollment ID: I20130715000221 |
| Provider Name | Jessie M Surla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245656479 PECOS PAC ID: 6507099165 Enrollment ID: I20140506000810 |
| Provider Name | Victoria Castaneda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720092018 PECOS PAC ID: 3577720465 Enrollment ID: I20140519001381 |
| Provider Name | Christopher A Timmons |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063569887 PECOS PAC ID: 1850548603 Enrollment ID: I20140812001200 |
| Provider Name | Anne Louise Gomez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740281799 PECOS PAC ID: 9335231844 Enrollment ID: I20140910000338 |
| Provider Name | Hector E Santiago Belledonne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487852919 PECOS PAC ID: 4385885268 Enrollment ID: I20150114000725 |
| Provider Name | Brandon Cometti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265792022 PECOS PAC ID: 1658692488 Enrollment ID: I20150605000551 |
| Provider Name | Daniel Ridout |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265427504 PECOS PAC ID: 9830132984 Enrollment ID: I20150825003746 |
| Provider Name | Darla Melton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063934818 PECOS PAC ID: 6204108350 Enrollment ID: I20170824000291 |
| Provider Name | Zibin Zhao |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164777629 PECOS PAC ID: 0244522134 Enrollment ID: I20170828003421 |
| Provider Name | Alyssa Gallegos |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1639612401 PECOS PAC ID: 9032484878 Enrollment ID: I20171004003321 |
| Provider Name | Megan Leigh Brandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598283145 PECOS PAC ID: 1254697477 Enrollment ID: I20171103001820 |
| Provider Name | Kim Hestand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104356963 PECOS PAC ID: 1153688262 Enrollment ID: I20171128001942 |
| Provider Name | Ann Marie Matakas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265793319 PECOS PAC ID: 3375835424 Enrollment ID: I20180301001507 |
| Provider Name | Cathy R Xu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609078831 PECOS PAC ID: 7012192305 Enrollment ID: I20180313000256 |
| Provider Name | Anthony Alexander Anagnostou |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427450568 PECOS PAC ID: 7113275306 Enrollment ID: I20180803001561 |
| Provider Name | Derek B Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912944661 PECOS PAC ID: 0143225276 Enrollment ID: I20180912002295 |
| Provider Name | Keisha Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508318494 PECOS PAC ID: 3072898246 Enrollment ID: I20180926003432 |
| Provider Name | Nkechinyelu Vivian Nnebe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982886123 PECOS PAC ID: 1658622766 Enrollment ID: I20180927002898 |
| Provider Name | Mary Ellen Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316415979 PECOS PAC ID: 6204170665 Enrollment ID: I20181212000701 |
| Provider Name | Erica Elizabeth Guerrero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598230112 PECOS PAC ID: 7315283439 Enrollment ID: I20190110002473 |
| Provider Name | Leticia Medrano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023580073 PECOS PAC ID: 4385983105 Enrollment ID: I20190221002864 |
| Provider Name | Richard Saul Diaz Tushman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1568493773 PECOS PAC ID: 3779589072 Enrollment ID: I20190313001680 |
| Provider Name | Cynthia A Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265836639 PECOS PAC ID: 3678897931 Enrollment ID: I20190520000944 |
| Provider Name | Richard Michael Rembecki |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003884792 PECOS PAC ID: 4789831546 Enrollment ID: I20190607001542 |
| Provider Name | Sharef W Al-mulaabed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013360353 PECOS PAC ID: 8527393743 Enrollment ID: I20190710003207 |
| Provider Name | Eric David Cohen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720065188 PECOS PAC ID: 2365491602 Enrollment ID: I20191003000239 |
| Provider Name | Omar Hashmi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033521257 PECOS PAC ID: 5991085938 Enrollment ID: I20191015003312 |
| Provider Name | Emily Kobayashi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447637210 PECOS PAC ID: 9931418316 Enrollment ID: I20201209000689 |
| Provider Name | Michael Mitchell |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1417042730 PECOS PAC ID: 1951371632 Enrollment ID: I20210105000716 |
| Provider Name | Kristen Denise Scatliffe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194086694 PECOS PAC ID: 4183977473 Enrollment ID: I20210223000806 |
| Provider Name | Elia Charbel Abboud |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316380751 PECOS PAC ID: 5890023097 Enrollment ID: I20210817000880 |
| Provider Name | Kathleen Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225635808 PECOS PAC ID: 2961816384 Enrollment ID: I20211007003177 |
| Provider Name | Katrina Nicole Kelly |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013674605 PECOS PAC ID: 1658765482 Enrollment ID: I20220222000117 |
| Provider Name | Darren Ramoutar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1578706172 PECOS PAC ID: 1456580356 Enrollment ID: I20220324002706 |
| Provider Name | William John Horan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801880687 PECOS PAC ID: 0648379255 Enrollment ID: I20220830004065 |
| Provider Name | David Rutledge |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588681183 PECOS PAC ID: 2062325467 Enrollment ID: I20221005000677 |
| Provider Name | Ilene Lewis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760641930 PECOS PAC ID: 9335383843 Enrollment ID: I20221007001991 |
| Provider Name | Samuel Itie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952794687 PECOS PAC ID: 4688951544 Enrollment ID: I20221027003215 |
| Provider Name | Bennet Togbe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487983540 PECOS PAC ID: 7810139466 Enrollment ID: I20221213000047 |
| Provider Name | Tariq Sibghat Siddiqui |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1487879300 PECOS PAC ID: 0648332486 Enrollment ID: I20230307002345 |
| Provider Name | John Lally |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1407390339 PECOS PAC ID: 7517297971 Enrollment ID: I20230320000244 |
| Provider Name | Giovanni Salerno |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942242698 PECOS PAC ID: 8325947237 Enrollment ID: I20230427003049 |
| Provider Name | Roxanne Mickelson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1295081248 PECOS PAC ID: 3971977018 Enrollment ID: I20230501002645 |
| Provider Name | Ryan M Kiser |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144751165 PECOS PAC ID: 2365713799 Enrollment ID: I20230710003444 |
| Provider Name | James Chohonis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962817247 PECOS PAC ID: 2466761549 Enrollment ID: I20230713004242 |
| Provider Name | Brian Charles Cusick |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174578793 PECOS PAC ID: 5496648578 Enrollment ID: I20230816001144 |
| Provider Name | Aman Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1013399286 PECOS PAC ID: 9234437237 Enrollment ID: I20230829003993 |
| Provider Name | Katherine A Baugh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558758359 PECOS PAC ID: 1355720863 Enrollment ID: I20230908000253 |
| Provider Name | Louis John Melendez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649699935 PECOS PAC ID: 7315163060 Enrollment ID: I20231213004006 |
| Provider Name | Rebel Mary Reavis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811753460 PECOS PAC ID: 1759720121 Enrollment ID: I20240418000105 |
| Provider Name | Mona Homafar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790171668 PECOS PAC ID: 6800237306 Enrollment ID: I20240515002308 |
| Provider Name | Janet Greenholz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912967886 PECOS PAC ID: 9335271113 Enrollment ID: I20240606001527 |
Donald J Willis D.o. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 313 W Country Club Rd, Suite 9, Roswell, NM 88201 Phone: 575-624-2095 Fax: 575-627-5721 | |
Southern New Mexico Medical Association, Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 W. Country Club Rd, Roswell, NM 88201 Phone: 505-623-1442 Fax: 505-623-3835 | |
App Of New Mexico Hm Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 405 W Country Club Rd, Roswell, NM 88201 Phone: 575-622-8170 Fax: 629-216-0568 | |
Roswell Hospital Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 712 W Hobbs St, Roswell, NM 88203 Phone: 575-623-5263 | |
Roswell Osteopathic Medical Clinic, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 W. Hobbs St., Roswell, NM 88203 Phone: 575-623-3311 Fax: 575-622-1273 | |
Lovelace Health System, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1627 S Union Ave, Roswell, NM 88203 Phone: 575-208-0106 | |
Eye Catchers Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 204 E College Blvd, Roswell, NM 88201 Phone: 575-625-9800 Fax: 575-624-1724 |