ZIA PRIMARY CARE, LLC
NPI 1831802230
Family Medicine in Edgewood, NM

Active since December 30, 2022CLIA 32D2293498 · Waiver
104 QUAIL TRL STE B, EDGEWOOD, NM 87015(505) 926-9800 Get Directions Write a Review

NPPES record last updated: January 28, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 28, 2023, Jan 20, 2023, Dec 30, 2022 (3 updates tracked since 2022).

About Zia Primary Care, Llc NPPES

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

ZIA PRIMARY CARE, LLC (NPI 1831802230) is a healthcare organization registered as a family medicine in Edgewood, New Mexico and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through November 8, 2027 and lists Ashley Autrey, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1831802230
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameZIA PRIMARY CARE, LLC
Location Address104 QUAIL TRL STE BEdgewood, NM 87015-7197
Mailing Address104 Quail Trl Ste BEdgewood, NM 87015-7197 · (505) 926-9800 · Fax (505) 926-9722
Organization SubpartNo
Authorized OfficialAshley AutreyCredentialing · (505) 249-1369
Enumeration DateDecember 30, 2022
Last NPPES UpdateJanuary 28, 20233 updates tracked since enumeration
NPPES CertifiedJanuary 28, 2023
✔ NPI 1831802230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ 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.
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
104 QUAIL TRL STE B, Edgewood, NM 87015

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Zia Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Zia Primary Care, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Nurse Practitioner
NPI 1720269178
104 QUAIL TRL UNIT B
Edgewood, NM 87015
(505) 208-0204
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1861028102
7 MUNICIPAL WAY
Edgewood, NM 87015
(505) 281-3406
✔ PECOS✔ Accepts Medicare2.0 mi

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 32D2293498

Zia Primary Care, LLC · Edgewood, NM
Active · expires Nov 8, 2027
CLIA Number32D2293498
Laboratory TypePhysician Office
Certificate Effective DateNovember 9, 2025
Certificate Expiration DateNovember 8, 2027
Laboratory DirectorJodi Dettman
Laboratory Phone(505) 926-9800
Laboratory LocationZia Primary Care, LLC104 Quail Trail Ste B, Edgewood, NM 87015
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Zia Primary Care, LLC's NPI number?

The NPI number for Zia Primary Care, LLC is 1831802230. It was assigned to this organization in the NPPES registry on December 30, 2022.

Where is Zia Primary Care, LLC located?

Zia Primary Care, LLC is located at 104 Quail Trl Ste B, Edgewood, NM 87015. The listed phone number is (505) 926-9800.

What is Zia Primary Care, LLC's specialty?

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

Is Zia Primary Care, LLC enrolled in Medicare?

Yes. Zia Primary Care, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Zia Primary Care, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Zia Primary 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Zia Primary Care, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 32D2293498) is associated with this NPI, valid through November 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 Zia Primary Care, LLC was last updated on January 28, 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.