1528040268 NPI number — NICHOLAS J ROWLEY MD

Table of content: NICHOLAS J ROWLEY MD (NPI 1528040268)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528040268 NPI number — NICHOLAS J ROWLEY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROWLEY
Provider First Name:
NICHOLAS
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528040268
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 COMMERCE WAY
Provider Second Line Business Mailing Address:
STE 104
Provider Business Mailing Address City Name:
CLOVIS
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88101-4775
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-762-3385
Provider Business Mailing Address Fax Number:
575-762-3386

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
201 COMMERCE WAY
Provider Second Line Business Practice Location Address:
STE 104
Provider Business Practice Location Address City Name:
CLOVIS
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88101-4775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-762-3385
Provider Business Practice Location Address Fax Number:
575-762-3386
Provider Enumeration Date:
11/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X , with the licence number:  76258 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207YX0602X , with the licence number: 76258 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 850253170 . This is a "HEALTHSMART" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 25095 . This is a "PRESBYTERIAN HEALTHCARE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 850253170 . This is a "MOLINA HEALTHCARE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: OONM002357 . This is a "BCBS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 23663 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 850253170 . This is a "WISCONSIN PHYSICIAN SVCS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 073050901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 201008586 . This is a "PRESBYTERIAN SALUD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 850253170 . This is a "CARE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 850253170 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 850253170 . This is a "LOVELACE HEALTHCARE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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