Active NPI
Monique McCardle, PTA
- Physical Therapy Assistant
- Carlsbad, NM
National Provider Identifier
1295457695
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA1982
- Practice address
- 1801 W Lea St
Carlsbad, NM 88220-3785 - Phone
- (575) 234-3303
- NPI assigned
- Sep 13, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA1982 | NM | Primary |
Addresses
Primary practice location
1801 W Lea St
Carlsbad, NM 88220-3785
Mailing address
513 N Olive St
Carlsbad, NM 88220-4229
Phone (503) 719-3754
Other practice location 1
1609 W Lea St
Carlsbad, NM 88220-3752
Phone (575) 234-3304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA1982 | NM | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1295457695",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 N OLIVE ST",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "882204229",
"telephone_number": "503-719-3754"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 W LEA ST",
"city": "CARLSBAD",
"state": "NM",
"postal_code": "882203785",
"telephone_number": "575-234-3303"
}
],
"practiceLocations": [
{
"address_1": "1609 W Lea St",
"address_purpose": "LOCATION",
"city": "Carlsbad",
"state": "NM",
"postal_code": "882203752",
"country_code": "US",
"telephone_number": "575-234-3304",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCCARDLE",
"first_name": "MONIQUE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NM",
"license": "PTA1982",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carlsbad, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.