Jal Hospital District
NPI 1558583005ActiveOrganization· Clinic/Center· Jal, NM
Clinic/Center in Jal, New Mexico, registered in NPPES in May 2007. The authorized official on file is Liza Tackett, Credentialing Administrator. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1558583005 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 3, 2007 |
| Last updated in NPPES | Jul 24, 2024 |
| Certified by provider | Jul 24, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | 6179 | NM |
| General Practice | 208D00000X | — | — |
| Physical Therapist | 225100000X | — | — |
| Nurse Practitioner, Family | 363LF0000X | — | — |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NM) |
|---|