ROSWELL CLINIC CORP NPI 1649267618

NPI Information

NPI: 1649267618
Provider Name: ROSWELL CLINIC CORP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
CLIA Number: 32D2006103
Address: 350 W COUNTRY CLUB RD
STE 201
ROSWELL, NM
ZIP 88201
Phone: (888) 801-5554

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NPI Details

ROSWELL CLINIC CORP is a family medicine in Roswell, NM. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ROSWELL CLINIC CORP NPI is 1649267618. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

350 W COUNTRY CLUB RD
STE 201
ROSWELL, NM
ZIP 88201-205
Phone: (888) 801-5554

The provider's authorized official is Jennifer L Jackson .
The authorized official title is Senior Director, Enrollment and has the following contact phone number (877) 892-9815.

The CLIA number assigned to this NPI record is 32D2006103 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 10/4/2005 and was last updated on 1/25/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License State	Primary
1	207R00000X	Internal Medicine			No
2	207RC0000X	Internal Medicine	Cardiovascular Disease		No
3	207RP1001X	Internal Medicine	Pulmonary Disease		No
4	207RS0012X	Internal Medicine	Sleep Medicine		No
5	207V00000X	Obstetrics & Gynecology			No
6	207X00000X	Orthopaedic Surgery			No
7	208600000X	Surgery			No
8	207Q00000X	Family Medicine		NEW MEXICO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	NPI AND TIN	OTHER	NEW MEXICO	BCBS
2	DA5509	OTHER	NEW MEXICO	RR MEDICARE
3	60806516	MEDICAID	NEW MEXICO
4	DD5451	OTHER	NEW MEXICO	RR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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