NPIMap

Organization Active NPI

Physical Therapy Care, LLC

  • Physical Therapist
  • Clovis, NM
National Provider Identifier
1255848057
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4234 Issued in NM
Legal business name
PHYSICAL THERAPY CARE, LLC
Practice address
1609 N Prince St
Clovis, NM 88101-4850
Phone
(575) 742-6806
NPI assigned
Jan 3, 2018
Last updated
Oct 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Authorized official

Name
Dr. Logan Arden Kanode, DPTNPI 1992049894
Title
Physical Therapist, Owner
Phone
(575) 742-6806

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4234 NM Primary

Addresses

Primary practice location

1609 N Prince St
Clovis, NM 88101-4850

Mailing address

1609 N Prince St
Clovis, NM 88101-4850
Phone (575) 935-0360

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603929600000",
    "number": "1255848057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 N PRINCE ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014850",
            "telephone_number": "575-935-0360",
            "fax_number": "575-935-0361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 N PRINCE ST",
            "city": "CLOVIS",
            "state": "NM",
            "postal_code": "881014850",
            "telephone_number": "575-742-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "KANODE",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "ARDEN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "575-742-6806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2020; 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.