Dominic Jacob Campos Jr., LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT-2023-0006 Issued in NM

Practice address

916 E Hill Ave
Gallup, NM 87301-5572

Phone

(505) 721-6513

NPI assigned

Aug 1, 2023

Last updated

Aug 1, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1356023279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 E HILL AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015572",
            "telephone_number": "505-721-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "916 E HILL AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015572",
            "telephone_number": "505-721-6513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4701 Irving Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871143903",
            "country_code": "US",
            "telephone_number": "505-721-6513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "DOMINIC",
        "middle_name": "JACOB",
        "name_suffix": "Jr.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NM",
            "license": "MT-2023-0006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Calavaza
• Michael Dwayne Calhoun
• James Joseph Campbell, M.D.
• Rosie Campbell, RN
• Andrea R Campos, RN
• Veronica Campos
• Edward Canete
• Richard B Canning, RN
• John Patrick Cannistraro, REGISTERED NURSE
• Nancy Canto

• Massage Therapist in Gallup, NM
• Providers in Gallup, NM by specialty
• Massage Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; 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.