Jonathan Christian Benavidez, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA1531 Issued in NM

Practice address

8820 Horizon Blvd NE
Albuquerque, NM 87113-1689

Phone

(505) 998-1551

NPI assigned

Dec 14, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1033705058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25117 SW PARKWAY AVE STE D",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970709697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 HORIZON BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871131689",
            "telephone_number": "505-998-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENAVIDEZ",
        "first_name": "JONATHAN",
        "middle_name": "CHRISTIAN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-14",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "PTA1531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Benavidez
• Ezekiel Martin Benavidez
• Iven Victor Benavidez
• Jacqueline Nicole Benavidez, APRN-CNP
• Jennifer A Benavidez, PTA
• Joseph Benavidez, BMS
• Julian R. Benavidez, MD
• Mario Benavidez, MD
• Michael Cordaro Benavidez, OTD
• Renee Brittany Benavidez, LPCC

• Physical Therapy Assistant in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physical Therapy Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.