Individual provider Active NPI

Isabel Gonzales, PTA

  • Physical Therapy Assistant
  • Albuquerque, NM
National Provider Identifier
1003173840
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-0637 Issued in NM
Practice address
1100 Central SE
Albuquerque, NM 87106-4930
Phone
(505) 841-1125
Fax
(505) 841-1737
NPI assigned
Apr 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-0637 NM Primary

Addresses

Primary practice location

1100 Central SE
Albuquerque, NM 87106-4930

Mailing address

1100 Central SE
Albuquerque, NM 87106-4930
Phone (505) 841-1125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A-0637NMMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1003173840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1125",
            "fax_number": "505-841-1737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064930",
            "telephone_number": "505-841-1125",
            "fax_number": "505-841-1737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ISABEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-0637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.