Active NPI
Karen E McClary, PT
- Physical Therapist
- Las Cruces, NM
National Provider Identifier
1174830111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4149
- Practice address
- 2205 S Main St
Las Cruces, NM 88005-3113 - Phone
- (575) 652-3515
- Fax
- (575) 652-3518
- NPI assigned
- Sep 13, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60185600 | WA | |
| Physical Therapist | 225100000X | 4149 | NM | Primary |
Addresses
Primary practice location
2205 S Main St
Las Cruces, NM 88005-3113
Mailing address
2404 S. Locust St
Ste 5
Las Cruces, NM 88001-5789
Phone (575) 521-4188
Other identifiers 15
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03339MC | Other | WA | REGENCE |
| 0333MC | Other | WA | REGENCE |
| 0334MC | Other | WA | REGENCE |
| 1174830111 | Other | WA | DSHS |
| 0270986 | Other | WA | DEPT OF L&I |
| 0336MC | Other | WA | REGENCE |
| 0270990 | Other | WA | DEPT OF L&I |
| 0270993 | Other | WA | DEPT OF L&I |
| 0341MC | Other | WA | REGENCE |
| P00893794 | Other | WA | RAILROAD MEDICARE |
| 0332MC | Other | WA | REGENCE |
| 0335MC | Other | WA | REGENCE |
| 0271004 | Other | WA | DEPT OF L&I |
| 0338MC | Other | WA | REGENCE |
| 0340MC | Other | WA | REGENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NM
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
4151 Camino Coyote
Las Cruces, NM 88011-7096
Phone (575) 522-0484
Merit-based Incentive Payment System (MIPS)
- Final score
- 19.58 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 65.27
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4149 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy and Rehabilitation Services of Las Cruces, LLC | Physical Therapist | Current | Accepting new patients |
| Real View Diagnostics LLC | Physical Therapist | Past | Accepting new patients |
| Integrated Rehabilitation Group, PC | Physical Therapist | Past | Accepting new patients |
| Elixir Physical Therapy LLC | Physical Therapist | Past | Accepting new patients |
Locations
4151 Camino Coyote
Las Cruces, NM 88011
Phone (575) 522-0484
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Las Cruces, NM
- NPI 1740733377
Physical Therapist
-
- Physical Therapist
- Springfield, OH
- NPI 1255682100
-
- Physical Therapy Clinic/Center
- Marysville, WA
- NPI 1215201801
Physical Therapist
-
- Physical Therapist
- Canutillo, TX
- NPI 1336882026
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445817600000",
"number": "1174830111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2404 S. LOCUST ST",
"address_2": "STE 5",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880015789",
"telephone_number": "575-521-4188",
"fax_number": "575-521-3668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2205 S MAIN ST",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053113",
"telephone_number": "575-652-3515",
"fax_number": "575-652-3518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLARY",
"first_name": "KAREN",
"middle_name": "E",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-13",
"last_updated": "2015-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60185600",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "4149",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "03339MC",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "0333MC",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "0334MC",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DSHS",
"identifier": "1174830111",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF L&I",
"identifier": "0270986",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "0336MC",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF L&I",
"identifier": "0270990",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF L&I",
"identifier": "0270993",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "0341MC",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00893794",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "0332MC",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "0335MC",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF L&I",
"identifier": "0271004",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "0338MC",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "0340MC",
"state": "WA"
}
],
"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 Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.