Immune Co Medical Group PA
NPI 1285452458 · Internal Medicine Physician · Roswell, NM
Immune Co Medical Group PA is a Internal Medicine Physician organization in Roswell, NM (NPI 1285452458).
Provider details
- NPI number
- 1285452458
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ariana Thacker, Authorized Official(512) 789-7580
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Medical Physician Assistant363AM0700X
Physician Assistants & Advanced Practice Nursing Providers
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
- Nurse's Aide376K00000X
Nursing Service Related Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Moldco
Registry dates
- Enumerated
- 2024-09-27
- Last updated
- 2024-09-27
- Certified
- 2024-09-26
Frequently asked questions
- What is Immune Co Medical Group PA's NPI number?
- Immune Co Medical Group PA's National Provider Identifier (NPI) is 1285452458, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Immune Co Medical Group PA?
- Immune Co Medical Group PA is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Immune Co Medical Group PA located?
- Immune Co Medical Group PA's practice location on file with NPPES is 2500 Brandon Way, Roswell, NM 88201-9799.
- What is Immune Co Medical Group PA's phone number?
- The practice phone number listed in the NPPES registry for Immune Co Medical Group PA is (512) 789-7580.
- Who is the authorized official for Immune Co Medical Group PA?
- The authorized official listed on Immune Co Medical Group PA's NPPES record is Ariana Thacker, Authorized Official. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Immune Co Medical Group PA's NPI active?
- Yes — Immune Co Medical Group PA's NPI (1285452458) is active in the NPPES registry as of the last update on 2024-09-27.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.