NPIMap

Organization Active NPI

Elite Ortho-Therapy and Sports Medicine, LLC

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1174869259
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1994 Issued in NM
Legal business name
ELITE ORTHO-THERAPY AND SPORTS MEDICINE, LLC
Practice address
2125 Louisiana Blvd NE
Suite 160
Albuquerque, NM 87110-5416
Phone
(505) 252-4080
NPI assigned
Dec 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Beau B Hightower, DC
Title
Owner
Phone
(505) 252-4080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1994 NM Primary

Addresses

Primary practice location

2125 Louisiana Blvd NE
Suite 160
Albuquerque, NM 87110-5416

Mailing address

2125 Louisiana Blvd NE
Suite 160
Albuquerque, NM 87110-5416
Phone (505) 252-4080

National Provider Directory

National Provider Directory

Locations

2125 Louisiana Blvd NE
Ste 160
Albuquerque, NM 87110
Phone (505) 252-4080

NPI Registry JSON

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1174869259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 LOUISIANA BLVD NE",
            "address_2": "SUITE 160",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105416",
            "telephone_number": "505-252-4080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 LOUISIANA BLVD NE",
            "address_2": "SUITE 160",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871105416",
            "telephone_number": "505-252-4080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE ORTHO-THERAPY AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-18",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "HIGHTOWER",
        "authorized_official_first_name": "BEAU",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-252-4080",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "1994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.