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DE BACA FAMILY PRACTICE CLINIC
NPI 1699082644
Clinic/Center - Federally Qualified Health Center (FQHC) in Fort Sumner, NM

Active since September 10, 2010
1001 SUMNER AVE, FORT SUMNER, NM 88119(575) 355-4431(575) 355-4432 Get Directions Write a Review

NPPES record last updated: October 14, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About De Baca Family Practice Clinic NPPES

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

DE BACA FAMILY PRACTICE CLINIC (NPI 1699082644), doing business as De Baca Family Practice Clinic/school Site, is a healthcare organization registered as a federally qualified health center (fqhc) in Fort Sumner, New Mexico and active in the NPI registry since September 2010. The organization lists Lisa Walraven, Ceo, as its authorized official.

NPPES Registry Identity

NPI1699082644
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameDE BACA FAMILY PRACTICE CLINIC
Location Address1001 SUMNER AVEFort Sumner, NM 88119-0349
Mailing AddressPo Box 349Fort Sumner, NM 88119-0349 · (575) 355-2414 · Fax (575) 355-7894
Phone(575) 355-4431
Fax(575) 355-4432
Organization SubpartYes
Authorized OfficialLisa WalravenCeo · (575) 355-2420
Enumeration DateSeptember 10, 2010
Last NPPES UpdateOctober 14, 2025
NPPES CertifiedOctober 14, 2025
✔ NPI 1699082644 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
License✔ Licensed in NM · 3069
1001 SUMNER AVE, Fort Sumner, NM 88119
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Other Names 1

Doing Business AsDe Baca Family Practice Clinic/school Site

Other Identifiers 1

Medicaid38003384NM

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan, Ambetter of Oklahoma.Insurance ›

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 De Baca Family Practice Clinic's NPI number?

The NPI number for De Baca Family Practice Clinic is 1699082644. It was assigned to this organization in the NPPES registry on September 10, 2010. The provider is doing business as De Baca Family Practice Clinic/School Site.

Where is De Baca Family Practice Clinic located?

De Baca Family Practice Clinic is located at 1001 Sumner Ave, Fort Sumner, NM 88119. The listed phone number is (575) 355-4431.

What is De Baca Family Practice Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

What insurance does De Baca Family Practice Clinic accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list De Baca Family Practice Clinic as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for De Baca Family Practice Clinic was last updated on October 14, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.