La Luz Therapy Services

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

4196 Issued in NM

Legal business name

LA LUZ THERAPY SERVICES

Practice address

5400 Sevilla Ave NW Ste E
Albuquerque, NM 87120-1853

Phone

(505) 363-9582

Fax

(505) 214-5137

NPI assigned

Mar 4, 2017

Last updated

Nov 30, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marisa RoddyNPI 1972853026

Title

Owner

Phone

(505) 363-9582

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Marisa Pilar Roddy, DPT

  • Pediatric Physical Therapist
  • Albuquerque, NM
  • NPI 1972853026

  Pediatrics

  Medicare reassignment Care Compare group NPD Authorized official
• Miranda Blair

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1831970516
  Medicare reassignment Care Compare group NPD
• Deanna Lucero, DPT

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1477282630
  Medicare reassignment Care Compare group NPD
• Anthony R Roddy, PT, DPT

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1730501883
  Medicare reassignment NPD

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

{
    "created_epoch": "1488585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575072000000",
    "number": "1104366533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 MESA WOOD PL NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871206565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 SEVILLA AVE NW STE E",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201853",
            "telephone_number": "505-363-9582",
            "fax_number": "505-214-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA LUZ THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-04",
        "last_updated": "2019-11-30",
        "status": "A",
        "authorized_official_last_name": "RODDY",
        "authorized_official_first_name": "MARISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-363-9582"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NM",
            "license": "4197",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NM",
            "license": "4196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1730501883",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1972853026",
            "state": "NM"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://laluztherapy.wixsite.com/la-luz",
            "affiliation": "N",
            "address_1": "5400 Sevilla Ave NW Ste E",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871201853",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• La Cueva Family Healthcare Inc
• La Familia Inc.
• La Familia, Inc. (La Familia-Namaste)
• La Luz Counseling, LLC
• La Luz Mental Wellness LLC
• La Mariposa Counseling LLC
• La Paloma Clinic LLC
• Tina C La Turner, M.A. LPCC
• Johnathan La Ve
• La Vida Llena

• Physical Therapy Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Physical Therapy Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.