Provider Demographics
NPI:1902921026
Name:JILL A. RHYMES, M.D., LLC
Entity Type:Organization
Organization Name:JILL A. RHYMES, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RHYMES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-983-9622
Mailing Address - Street 1:531 HARKLE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4753
Mailing Address - Country:US
Mailing Address - Phone:505-983-9622
Mailing Address - Fax:
Practice Address - Street 1:531 HARKLE RD
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4753
Practice Address - Country:US
Practice Address - Phone:505-983-9622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM00NM009J48OtherBCBS NEW MEXICO
NM58424873Medicaid
NM00NM009J48OtherBCBS NEW MEXICO