Organization
ROSWELL CLINIC CORP
Active
Parent organization
ROSWELL CLINIC CORP
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROSWELL CLINIC CORP
Authorized official
JENNIFER L JACKSON (SENIOR DIRECTOR, ENROLLMENT)
(877) 892-9815
Entity
Organization
Contact information
Practice address
350 W COUNTRY CLUB RD, STE 201, ROSWELL, NM 88201-5205
(888) 801-5554
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7000
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NM
207R00000X
Internal Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60806516
—
NM
01
—
DA5509
RR MEDICARE
NM
01
—
DD5451
RR MEDICARE
NM
01
—
NPI AND TIN
BCBS
NM
Enumeration date
10/04/2005
Last updated
01/25/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us