State of New Mexico

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

STATE OF NEW MEXICO

Practice address

3695 Hot Springs Blvd
Las Vegas, NM 87701-9549

Phone

(505) 454-2100

NPI assigned

Dec 14, 2006

Last updated

Jun 2, 2009By 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

Mr. Charles R. Jaramillo

Title

Finance Director

Phone

(505) 454-2306

Specialties & licenses 5

Addresses

Other identifiers 2

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243900800000",
    "number": "1124180419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3695 HOT SPRINGS BLVD.",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877019549",
            "telephone_number": "505-454-2100",
            "fax_number": "505-454-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3695 HOT SPRINGS BLVD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877019549",
            "telephone_number": "505-454-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATE OF NEW MEXICO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2009-06-02",
        "status": "A",
        "authorized_official_last_name": "JARAMILLO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "505-454-2306",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH PRO",
            "identifier": "38864",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "7577",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Stanley, PHARM.D., BCPP, PHC
• Rhonda Kay Stanley, PHYSICAL THERAPIST
• Sylvia M Starr, LISW
• Karen Stashek, PHD, CLC,CMH, MH, RM
• State of New Mexico (New Mexico Behavioral Health Institute @ Las Vegas)
• State of New Mexico (New Mexico Behavioral Health Institute @ Las Vegas)
• State of New Mexico (New Mexico Behavioral Health Institue at Las Vegas)
• State of New Mexico
• State of New Mexico (New Mexico Behavioral Health Institute)
• State of New Mexico (New Mexico Behavioral Health Institue at Las Vegas)

• Physical Therapist in Las Vegas, NM
• Providers in Las Vegas, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.