CROSS HEART CARE LLC
NPI 1790453561
Nurse Practitioner - Family in Fort Sumner, NM
About Cross Heart Care Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CROSS HEART CARE LLC (NPI 1790453561) is a healthcare organization registered as a family in Fort Sumner, New Mexico and active in the NPI registry since September 2021. The organization holds a CLIA Waiver certificate valid through September 8, 2027 and lists Mary Molly Kenyon, Owner Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Cross Heart Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Cross Heart Care LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 32D2235539
Cross Heart Care, LLC · Fort Sumner, NMFrequently 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 Cross Heart Care LLC's NPI number?
The NPI number for Cross Heart Care LLC is 1790453561. It was assigned to this organization in the NPPES registry on September 5, 2021.
Where is Cross Heart Care LLC located?
Cross Heart Care LLC is located at 848 North 4th Street, Fort Sumner, NM 88119. The listed phone number is (575) 355-2273.
What is Cross Heart Care LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Cross Heart Care LLC enrolled in Medicare?
Yes. Cross Heart Care LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Cross Heart Care LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Cross Heart Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Cross Heart Care LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 32D2235539) is associated with this NPI, valid through September 8, 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 Cross Heart Care LLC was last updated on October 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Cross Heart Care Llc · NPI 1790453561
Family organization in Fort Sumner, New Mexico. Organization record, active in the CMS NPPES registry since September 5, 2021.
## Identity
- **NPI:** 1790453561 (Entity type: Organization)
- **Enumerated:** September 5, 2021
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **Organization subpart:** No
- **Authorized official:** Mary Kenyon, OWNER PROVIDER
## Practice location
- **Address:** 848 NORTH 4TH STREET, Fort Sumner, NM 88119-9411
- **Phone:** (575) 355-2273
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 27, 2021
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1790453561) · Data from the CMS NPPES public registry.