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Governance Register
US nonprofit · EIN 861037107 · Fort Sumner, NMiSource and licenceOrganisation record IRS Exempt Organizations Business Master File (EIN 861037107) - NTEE activity code, address.Board and officers IRS Form 990 annual filings, Part VII (directors, trustees, officers, key employees), read year by year to observe time served.Latest return IRS Form 990 series e-file data - 990 for the year to 30 June 2025: assets, liabilities, staff, website, telephone, pay, related organisations (Schedule R).Renewal outlook Computed by Governance Register from the observed filing history and filed revenue. Not a statement that the organisation is recruiting.Deductibility IRS Publication 78 data (code PC), downloaded 18 October 2026.Licence US Federal Government public domain.How we handle data

De Baca Family Practice Clinic's network

10 peoplei10 people on this map.The large node is the subject of this page. Solid lines are what the register itself records (10). Form 990 filings give names without a person identifier; SEC insider filings carry a CIK.

The board

10 listediTime on the board is observed from the annual filings: the IRS files no appointment date, so the bar counts years from the first filing the person appears on - a lower bound, not a filed start date. Names are exactly as filed. The IRS publishes no person identifier, so this edition does not yet link a person across organisations.Time served and departures are observed across annual filings. Observed time served is a lower bound - a member may have joined before the first year on record. The organisation reported 10 voting members of its governing body on its latest Form 990 Part VI, which matches the board listed here.
NameRole as filedSinceOn the board
Becky HarrisDirector2023
3 yrs
Beverly0verton Sec2024
2 yrs
Bob JackDirector2019
7 yrs
Charlie WestDirector2019
7 yrs
HeatherMcConnell Dire2024
2 yrs
Joe SteeleDirector2019
7 yrs
John FallonV President2019
7 yrs
LarryWilliamson Pre2024
2 yrs
MarieDickermna Dire2024
2 yrs
VincentStallard Direc2024
2 yrs
Under 5 years5 to 6 years6 years or more

Officers and senior leadership

8 listediNamed in Part VII as officers, key employees or highest-compensated staff - not board members, shown for completeness.
NameTitle as filedOn the filings
CandanceKernall CNP2025
Darlene JenkinNpsince 2019
Greg McAlisterDentist2020
Greg McAllisteDentistsince 2019
Jack VickMDsince 2019
Laney PierceNpsince 2019
Lisa WalravenCEOsince 2023
Susan VickCFO2025

Pay and hours

year to 30 June 2025iFrom Part VII of the Form 990: compensation reported for each officer, director, trustee, key employee and highest-paid staff member, and the average hours a week they report. Most board members are unpaid; a blank means nothing was reported. Pay from related organisations is shown separately.
NameTitle as filedHours a weekPay from the organisationRelated organisationsOther
Jack VickDoctor40$267k
Greg McAllisteDentist32$132k
Laney PierceCNP40$128k
CandanceKernall CNP40$123k
Lisa WalravenCEO40$121k
Susan VickCFO40$115k
LarryWilliamson Pre5$0
John FallonV President2$0
Beverly0verton Sec5$0
Bob JackDirector1$0
VincentStallard Direc1$0
Joe SteeleDirector1$0
MarieDickermna Dire1$0
Charlie WestDirector1$0
HeatherMcConnell Dire1$0
Becky HarrisDirector1$0

About

Legal name
De Baca Family Practice Clinic
EIN
861037107
Address
Po Box 349, Fort Sumner, NM, 88119-0349
State
New Mexico
Mission
Providing healthcare services to the underserved in eastern new mexico (as filed on the Form 990)
Activity (NTEE)
E32 Health care
IRS classification
501(c)03 (tax-exempt under section 501(c)(3) where shown)
Classified purpose
Health Care
Size band
7 (IRS master file code)
Formed
2001
Principal officer
Larry Williamson (as named on the Form 990)
IRS ruling date
1 June 2002
Status
Code 01 (unconditional exemption)
Form 990 filings on record
6, latest 2025
IRS Publication 78
PC (contributions deductible)

Most connected

Longest observed on the filings

≥7years on the filingsBob Jack
≥7years on the filingsCharlie West
≥7years on the filingsJoe Steele
≥7years on the filingsJohn Fallon

Latest return

year to 30 June 2025iFigures from the newest Form 990 or 990-EZ in the IRS e-file releases of 2025 and 2026, for the year ending 30 June 2025. US dollars, as filed.
Total assets
$6.6m
Total liabilities
$4.4m
Net assets or fund balances
$2.2m
Contributions and grants received
$2.5m
Program service revenue
$1.4m
Employees
43