DE BACA FAMILY PRACTICE CLINIC
NPI 1740090729
Clinic/Center - Federally Qualified Health Center (FQHC) in Fort Sumner, NM

NPI Status: Active since January 10, 2025

Contact Information

678 AVENUE C
FORT SUMNER, NM
ZIP 88119
Phone: (575) 355-2417
Fax: (575) 355-2418

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  • Organization
  • Clinic/Center
  • Federally Qualified Health Center (FQHC)

About DE BACA FAMILY PRACTICE CLINIC

This page provides the complete NPI Profile along with additional information for De Baca Family Practice Clinic, a primary care provider established in Fort Sumner, New Mexico operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1740090729 assigned on January 2025. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's . The authorized official of this NPI record is Lisa Walraven (Ceo)

NPI
1740090729
Provider Legal Name
DE BACA FAMILY PRACTICE CLINIC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
678 AVENUE C FORT SUMNER, NM 88119
Location Phone
(575) 355-2417
Location Fax
(575) 355-2418
Mailing Address
PO BOX 349 FORT SUMNER, NM 88119
Mailing Phone
(575) 355-2414
Mailing Fax
(575) 355-2418
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
01-10-2025
Last Update Date
10-14-2025
Code Navigator

A primary care provider (PCP) like De Baca Family Practice Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Federally Qualified Health Center (FQHC)

Taxonomy Code
261QF0400X
Type
Ambulatory Health Care Facilities

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11223G0001XDental Providers

Dentist
General Practice

 

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

LISA WALRAVEN

Authorized Official Title
CEO
Authorized Official Phone
(575) 355-2420

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1740090729, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
4
Doubled → 8
Pos 4
0
Unchanged
Pos 5
0
Doubled → 0
Pos 6
9
Unchanged
Pos 7
0
Doubled → 0
Pos 8
7
Unchanged
Pos 9
2
Doubled → 4
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 0 → 0 0 → 0 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 8 + 0 + 0 + 9 + 0 + 7 + 4 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1740090729.

Other Providers at the Same Location


The following 13 providers are registered at the same or a nearby location.

Counselor
678 AVENUE C
FORT SUMNER, NM 88119
Counselor
678 AVENUE C
FORT SUMNER, NM 88119
Counselor
678 AVENUE C
FORT SUMNER, NM 88119
Counselor
678 AVENUE C
FORT SUMNER, NM 88119
Counselor
678 AVENUE C
FT. SUMNER, NM 88119
Counselor
678 AVENUE C
FT. SUMNER, NM 88119
Counselor
678 AVENUE C
FT. SUMNER, NM 88119
Counselor
678 AVENUE C
FORT. SUMNER, NM 88119
Counselor
678 AVENUE C
FT. SUMNER, NM 88119
Counselor
678 AVENUE C
FT. SUMNER, NM 88119
Counselor
678 AVENUE C
FORT SUMNER, NM 88119
Community/Behavioral Health
678 AVENUE C
FORT SUMNER, NM 88119
Counselor
678 AVENUE C
FORT SUMNER, NM 88119

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1740090729, enumerated as an "organization" on January 10, 2025.

The provider is located at 678 AVENUE C FORT SUMNER, NM 88119 and the phone number is (575) 355-2417.

Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).