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CIBOLA SPECIALTY ASSOCIATES
NPI 1003444647
Clinic/Center - Multi-Specialty in Grants, NM

Active since March 30, 2020CLIA 32D2275721 · Waiver
1208 BONITA ST, GRANTS, NM 87020(505) 287-4446 Get Directions Write a Review

NPPES record last updated: January 11, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 11, 2021, Mar 30, 2020 (2 updates tracked since 2020).

About Cibola Specialty Associates NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CIBOLA SPECIALTY ASSOCIATES (NPI 1003444647) is a healthcare organization registered as a multi-specialty in Grants, New Mexico and active in the NPI registry since March 2020. The organization holds a CLIA Waiver certificate valid through January 25, 2027 and lists Thomas Whelan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003444647
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameCIBOLA SPECIALTY ASSOCIATES
Location Address1208 BONITA STGrants, NM 87020-2234
Mailing Address1016 E Roosevelt AveGrants, NM 87020-2118 · (505) 287-4446 · Fax (505) 287-5213
Phone(505) 287-4446
Organization SubpartNo
Authorized OfficialThomas WhelanCeo · (505) 287-5300
Enumeration DateMarch 30, 2020
Last NPPES UpdateJanuary 11, 20212 updates tracked since enumeration
NPPES CertifiedJanuary 11, 2021
✔ NPI 1003444647 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedSurgeryTaxonomy 208600000X
1208 BONITA ST, Grants, NM 87020
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Other Identifiers 1

Medicaid46102NM

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 32D2275721

Cibola Specialty Associates · Grants, NM
Active · expires Jan 25, 2027
CLIA Number32D2275721
Laboratory TypePhysician Office
Certificate Effective DateJanuary 26, 2025
Certificate Expiration DateJanuary 25, 2027
Laboratory DirectorArnold W. Valdivia
Laboratory Phone(505) 287-6500
Laboratory LocationCibola Specialty Associates1208 Bonita Ave, Grants, NM 87020
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MATTHEW MUNSON PHARM D
Pharmacist
1208 BONITA ST
GRANTS, NM 87020
Cibola County (505) 287-4641
ARNOLD W. VALDIVIA, M.D., P.C.
Family Medicine
1208 BONITA ST
GRANTS, NM 87020
Cibola County (505) 287-4474
PHIL PARKHURST R.PH.
Pharmacist
1208 BONITA ST
GRANTS, NM 87020
Cibola County (505) 287-4641
MRS. VANESSA MARIAH MEZA CHW
Community Health Worker
1208 BONITA ST
GRANTS, NM 87020
Cibola County (505) 287-6500
PARKHURST PHARMACY
Pharmacy (Community/Retail Pharmacy)
1208 BONITA ST
GRANTS, NM 87020
Cibola County (505) 287-4641
ARNOLD W VALDIVIA M.D.
Family Medicine
1208 BONITA ST
GRANTS, NM 87020
Cibola County (505) 287-4474
PARKHURST PHARMACY
Pharmacy (Community/Retail Pharmacy)
1208 BONITA ST
GRANTS, NM 87020
Cibola County (505) 287-4641
RANDOLPH MATTILA
Pharmacist
1208 BONITA ST
GRANTS, NM 87020
Cibola County (505) 287-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cibola Specialty Associates's NPI number?

The NPI number for Cibola Specialty Associates is 1003444647. It was assigned to this organization in the NPPES registry on March 30, 2020.

Where is Cibola Specialty Associates located?

Cibola Specialty Associates is located at 1208 Bonita St, Grants, NM 87020. The listed phone number is (505) 287-4446.

What is Cibola Specialty Associates's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Cibola Specialty Associates hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 32D2275721) is associated with this NPI, valid through January 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Cibola Specialty Associates was last updated on January 11, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.