Taos Sports Medicine SRVS LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

TAOS SPORTS MEDICINE SRVS LLC

Doing business as

Taos MRI

Practice address

1398 Weimer Rd
Ste 203
Taos, NM 87571

Phone

(505) 737-0304

Fax

(505) 737-0383

NPI assigned

Jul 6, 2006

Last updated

Oct 16, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jocelyn Lucero

Title

Office Manager

Phone

(505) 737-0304

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Taos MRI Doing business as

Locations

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1225069230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 WEIMER RD",
            "address_2": "ST 203",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "505-737-0304",
            "fax_number": "505-737-0383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 WEIMER RD",
            "address_2": "STE 203",
            "city": "TAOS",
            "state": "NM",
            "postal_code": "87571",
            "telephone_number": "505-737-0304",
            "fax_number": "505-737-0383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAOS SPORTS MEDICINE SRVS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "LUCERO",
        "authorized_official_first_name": "JOCELYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "505-737-0304"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "NM3072",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65377273",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MALINE SALUD",
            "identifier": "PRCVA41646",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taos MRI",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taos Pueblo Division of Health and Community Services
• Taos Senior Living Managers LLC (Taos Retirement Village)
• Taos Senior Living Partners LP (Taos Village Home Health)
• Taos Senior Living Partners LP
• Taos Sports Medicine Services LLC (dba Taos MRI Services)
• Taos Surgical Specialties LLC
• Taos Therapeutic Massage LLC
• Taos Urgent Care, Inc
• Taos Whole Health Integrative Care, LLC
• Tommy A Tapia

• Physical Medicine & Rehabilitation Physician in Taos, NM
• Providers in Taos, NM by specialty
• Physical Medicine & Rehabilitation Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.