Immune Co Medical Group PA
NPI 1285452458ActiveOrganization· Internal Medicine· Roswell, NM
Internal Medicine in Roswell, New Mexico, registered in NPPES in September 2024. The authorized official on file is Ariana Thacker, Authorized Official.
Overview
| NPI | 1285452458 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 27, 2024 |
| Last updated in NPPES | Sep 27, 2024 |
| Certified by provider | Sep 26, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Physician Assistant, Medical | 363AM0700X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
| Nurse's Aide | 376K00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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