Individual provider Active NPI

Davynne Tealesa Burr, DPT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1215486923
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4918 Issued in NM
Practice address
505 Elm St NE
Albuquerque, NM 87102-2500
Phone
(505) 727-4927
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4918 NM Primary

Addresses

Primary practice location

505 Elm St NE
Albuquerque, NM 87102-2500

Mailing address

643 Cyan CT NW
Albuquerque, NM 87120-1133
Phone (505) 486-6848

Other names 1

  • Davynne Tealesa Atanasoff Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201123001007 NM Practitioner - Physical Therapist in Private Practice 9638580780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

111 Rio Rancho Blvd SE
Suite 110
Rio Rancho, NM 87124-7020
Phone (505) 727-4950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4918NMMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lovelace Unm Rehabilitation Hospital, LLC CurrentSince Nov 1, 2020 Accepting new patients
Lovelace Unm Rehabilitation Hospital LLC Current Accepting new patients
Lovelace Unm Rehabilitation Hospital LLC Physical Therapist CurrentSince Nov 1, 2020 Accepting new patients

Locations

4101 Indian School Rd NE
Ste 110
Albuquerque, NM 87110
Phone (505) 727-8360

505 Elm St NE
Albuquerque, NM 87102
Phone (505) 727-4700

111 Rio Rancho Blvd SE
#110
Rio Rancho, NM 87124
Phone (505) 727-4950

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1215486923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 CYAN CT NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871201133",
            "telephone_number": "505-486-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 ELM ST NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022500",
            "telephone_number": "505-727-4927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURR",
        "first_name": "DAVYNNE",
        "middle_name": "TEALESA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVYNNE",
            "last_name": "ATANASOFF",
            "middle_name": "TEALESA",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Sep 23, 2016; 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.

Verify at the official NPI Registry.