Active NPI
Damon Dwiggins, LMT
- Massage Therapist
- Las Cruces, NM
National Provider Identifier
1174780639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 5765
- Practice address
- 755 S Telshor Blvd
BLDG C Suite 201
Las Cruces, NM 88011-4688 - Phone
- (575) 640-2088
- Fax
- (575) 522-3959
- NPI assigned
- May 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 5765 | NM | Primary |
Addresses
Primary practice location
755 S Telshor Blvd
BLDG C Suite 201
Las Cruces, NM 88011-4688
Mailing address
755 S Telshor Blvd
BLDG C Suite 201
Las Cruces, NM 88011-4688
Phone (575) 640-2088
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 539707-07 | Other | NM | NATIONAL CERTIFICATION BOARD OF THERAPEUTIC MASSAGE |
| 5765 | Other | NM | NEW MEXICO MASSAGE THERAPY BOARD |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5765 | NM | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211328000000",
"number": "1174780639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 S TELSHOR BLVD",
"address_2": "BLDG C SUITE 201",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880114688",
"telephone_number": "575-640-2088",
"fax_number": "575-522-3959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 S TELSHOR BLVD",
"address_2": "BLDG C SUITE 201",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880114688",
"telephone_number": "575-640-2088",
"fax_number": "575-522-3959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWIGGINS",
"first_name": "DAMON",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-21",
"last_updated": "2008-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "5765",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL CERTIFICATION BOARD OF THERAPEUTIC MASSAGE",
"identifier": "539707-07",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEW MEXICO MASSAGE THERAPY BOARD",
"identifier": "5765",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.