Active NPI
Taylor Buessing, DPT
- Orthopedic Physical Therapist
- Cannon AFB, NM
National Provider Identifier
1366965238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- PT5449
- Practice address
- 224 W D. L. Ingram Avenue, BLDG. 1408
Cannon AFB, NM 88103-5014 - Phone
- (575) 784-2778
- NPI assigned
- Jul 21, 2017
- Last updated
- Oct 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3744 | NE | |
| Orthopedic Physical Therapist | 2251X0800X | PT5449 | NM | Primary |
Addresses
Primary practice location
224 W D. L. Ingram Avenue, BLDG. 1408
Cannon AFB, NM 88103-5014
Mailing address
224 W D. L. Ingram Avenue Building 1408
Cannon AFB, NM 88103-5014
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3744 | NE | MD | Physical Therapist |
| PT5449 | NM | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sentry Home Health Care LLC | Physical Therapist | Current | Accepting new patients |
| Sentry Safety and Physical Therapy Specialists, LLC | Physical Therapist | Current | Accepting new patients |
Locations
805 N Richardson Ave
Roswell, NM 88201
Phone (575) 363-3134
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physical Therapist
- Roswell, NM
- NPI 1619349743
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730246400000",
"number": "1366965238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "224 W D. L. INGRAM AVENUE BUILDING 1408",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "881035014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "224 W D. L. INGRAM AVENUE, BLDG. 1408",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "881035014",
"telephone_number": "575-784-2778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUESSING",
"first_name": "TAYLOR",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-07-21",
"last_updated": "2024-10-30",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NE",
"license": "3744",
"primary": false
},
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "NM",
"license": "PT5449",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cannon AFB, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.