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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SAN MIGUEL CLINIC CORP
NPI 1114920717
Family Medicine in Las Vegas, NM

Active since May 27, 2005
108 LEGION DR STE A, LAS VEGAS, NM 87701(505) 454-9499 Get Directions Write a Review

NPPES record last updated: September 28, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Sep 28, 2026, Oct 17, 2023, Mar 4, 2019 (3 updates tracked since 2019).

About San Miguel Clinic Corp NPPES

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

SAN MIGUEL CLINIC CORP (NPI 1114920717) is a healthcare organization registered as a family medicine in Las Vegas, New Mexico and active in the NPI registry since May 2005. The organization lists Shelly Mae Scoggin, Director Of Revenue Cycle, as its authorized official.

NPPES Registry Identity

NPI1114920717
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSAN MIGUEL CLINIC CORP
Location Address108 LEGION DR STE ALas Vegas, NM 87701-4898
Mailing AddressPo Box 18428Belfast, ME 04915-4079
Phone(505) 454-9499
Organization SubpartNo
Authorized OfficialShelly Mae ScogginDirector Of Revenue Cycle · (505) 426-3500
Enumeration DateMay 27, 2005
Last NPPES UpdateSeptember 28, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2026
✔ NPI 1114920717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
108 LEGION DR STE A, Las Vegas, NM 87701
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Other Identifiers 1

Medicaid47485817NM

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 San Miguel Clinic Corp's NPI number?

The NPI number for San Miguel Clinic Corp is 1114920717. It was assigned to this organization in the NPPES registry on May 27, 2005.

Where is San Miguel Clinic Corp located?

San Miguel Clinic Corp is located at 108 Legion Dr Ste A, Las Vegas, NM 87701. The listed phone number is (505) 454-9499.

What is San Miguel Clinic Corp's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for San Miguel Clinic Corp was last updated on September 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.