NPIMap

Organization Active NPI

Spine & Muscle Rehabilitation Inc

  • Mechanotherapist
  • Albuquerque, NM
National Provider Identifier
1396908653
Registry record updated Sep 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
MechanotherapistTaxonomy code 172M00000X
License
4933 Issued in NM
Legal business name
SPINE & MUSCLE REHABILITATION INC
Practice address
10400 Academy Rd NE
Suite #340
Albuquerque, NM 87111-7372
Phone
(505) 298-1558
Fax
(505) 298-7012
NPI assigned
Jul 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2009

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

Authorized official

Name
Kenneth G. Abbott
Title
Vice President
Phone
(505) 298-1558

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
MechanotherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 172M00000X 4933 NM Primary
MechanotherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 172M00000X 5499 NM
MechanotherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 172M00000X 6070 NM
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X R38331 NM
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X R35692 NM

Addresses

Primary practice location

10400 Academy Rd NE
Suite #340
Albuquerque, NM 87111-7372

Mailing address

Pob 20057
Albuquerque, NM 87154
Phone (505) 298-1558

National Provider Directory

National Provider Directory

Locations

10400 Academy Rd NE
Ste 230
Albuquerque, NM 87111
Phone (505) 298-1558

10400 Academy Rd NE
Ste 340
Albuquerque, NM 87111
Phone (505) 298-1558

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253491200000",
    "number": "1396908653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 20057",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87154",
            "telephone_number": "505-298-1558",
            "fax_number": "505-298-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10400 ACADEMY RD NE",
            "address_2": "SUITE #340",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871117372",
            "telephone_number": "505-298-1558",
            "fax_number": "505-298-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & MUSCLE REHABILITATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2009-09-21",
        "status": "A",
        "authorized_official_last_name": "ABBOTT",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "505-298-1558"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Mechanotherapist",
            "state": "NM",
            "license": "4933",
            "primary": true
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Mechanotherapist",
            "state": "NM",
            "license": "5499",
            "primary": false
        },
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Mechanotherapist",
            "state": "NM",
            "license": "6070",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "R38331",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NM",
            "license": "R35692",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2009; 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.