Individual provider Active NPI

Taylor Buessing, DPT

  • Orthopedic Physical Therapist
  • Cannon AFB, NM
National Provider Identifier
1366965238
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT5449 Issued in NM
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, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
3744NEMDPhysical Therapist
PT5449NMMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sentry Home Health Care LLC Physical Therapist CurrentSince Dec 21, 2021 Accepting new patients
Sentry Safety and Physical Therapy Specialists, LLC Physical Therapist CurrentSince Sep 1, 2021 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.

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.

Verify at the official NPI Registry.