ROSWELL CLINIC CORP
NPI 1417656869
Clinic/Center - Rural Health in Roswell, NM

Active since February 24, 2023CLIA 32D2139044 · Microscopy
300 W COUNTRY CLUB RD STE 230, ROSWELL, NM 88201(575) 622-1411 Get Directions Write a Review

NPPES record last updated: February 24, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Roswell Clinic Corp NPPES

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

ROSWELL CLINIC CORP (NPI 1417656869), doing business as Ponderossa Medical Associates, is a healthcare organization registered as a rural health in Roswell, New Mexico and active in the NPI registry since February 2023. The organization holds a CLIA Microscopy certificate valid through October 29, 2027 and lists Jennifer L Jackson, Sr Director, Provider Enrollment, as its authorized official.

NPPES Registry Identity

NPI1417656869
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameROSWELL CLINIC CORP
Location Address300 W COUNTRY CLUB RD STE 230Roswell, NM 88201-5240
Mailing AddressPo Box 689022Franklin, TN 37068-9022 · (615) 465-7385 · Fax (615) 628-6877
Organization SubpartNo
Authorized OfficialJennifer L JacksonSr Director, Provider Enrollment · (615) 465-3334
Enumeration DateFebruary 24, 2023
NPPES CertifiedFebruary 16, 2023
NPI 1417656869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
300 W COUNTRY CLUB RD STE 230, Roswell, NM 88201

Other Names 1

Doing Business AsPonderossa Medical Associates

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 for Provider-Performed Microscopy Procedures (PPMP) 32D2139044

Roswell Clinic Corp Dba Ponderosa Medical Associates · Roswell, NM
Active · expires Oct 29, 2027
CLIA Number32D2139044
Laboratory TypePhysician Office
Certificate Effective DateOctober 30, 2025
Certificate Expiration DateOctober 29, 2027
Laboratory DirectorDr. Richard Pinon
Laboratory Phone(575) 622-1411
Laboratory LocationRoswell Clinic Corp Dba Ponderosa Medical Associates300 W Country Club Rd, Suite 230, Roswell, NM 88201
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 6

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

Nurse Practitioner (Family)
300 W COUNTRY CLUB RD STE 230
ROSWELL, NM 88201
Nurse Practitioner (Family)
300 W COUNTRY CLUB RD STE 230
ROSWELL, NM 88201
Family Medicine
300 W COUNTRY CLUB RD STE 230
ROSWELL, NM 88201
Nurse Practitioner (Family)
300 W COUNTRY CLUB RD STE 230
ROSWELL, NM 88201
Nurse Practitioner (Family)
300 W COUNTRY CLUB RD STE 230
ROSWELL, NM 88201
Nurse Practitioner (Family)
300 W COUNTRY CLUB RD STE 230
ROSWELL, NM 88201

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 Roswell Clinic Corp's NPI number?

The NPI number for Roswell Clinic Corp is 1417656869. It was assigned to this organization in the NPPES registry on February 24, 2023. The provider is doing business as Ponderossa Medical Associates.

Where is Roswell Clinic Corp located?

Roswell Clinic Corp is located at 300 W Country Club Rd Ste 230, Roswell, NM 88201. The listed phone number is (575) 622-1411.

What is Roswell Clinic Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Roswell Clinic Corp hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 32D2139044) is associated with this NPI, valid through October 29, 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 Roswell Clinic Corp was last updated on February 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.