NPIMap

Organization Active NPI

Lifespan Therapy Services, Inc.

  • Occupational Therapist
  • Santa Fe, NM
National Provider Identifier
1225047459
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1562 Issued in NM
Legal business name
LIFESPAN THERAPY SERVICES, INC.
Practice address
826 Camino del Monte Rey Ste A2
Santa Fe, NM 87505-3961
Phone
(505) 954-9940
Fax
(505) 954-9946
NPI assigned
Aug 5, 2006
Last updated
Oct 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Authorized official

Name
Ms. Danusia Kidane, OTR/LNPI 1891865424
Title
Director
Phone
(505) 954-9940

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 1011 NM
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 1562 NM Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X 2423 NM

Addresses

Primary practice location

826 Camino del Monte Rey Ste A2
Santa Fe, NM 87505-3961

Mailing address

826 Camino del Monte Rey Ste A2
Santa Fe, NM 87505-3961
Phone (505) 954-9940

Other identifiers 2

IdentifierTypeStateIssuer
202006808OtherNMPRESBYTERIAN PROVIDER
A1205OtherNMMEDICAID WAIVER PROVIDER

National Provider Directory

National Provider Directory

Locations

826 Camino del Monte Rey
Ste A2
Santa Fe, NM 87505
Phone (505) 670-3378

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1225047459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 CAMINO DEL MONTE REY STE A2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053961",
            "telephone_number": "505-954-9940",
            "fax_number": "505-954-9946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 CAMINO DEL MONTE REY STE A2",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053961",
            "telephone_number": "505-954-9940",
            "fax_number": "505-954-9946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "KIDANE",
        "authorized_official_first_name": "DANUSIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-954-9940",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1011",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "1562",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "2423",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN PROVIDER",
            "identifier": "202006808",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WAIVER PROVIDER",
            "identifier": "A1205",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.