Daniel Pena, ATC, LPTA

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

4501 Biggs Avenue BLDG 939
Kirtland AFB, NM 87117-1908

Phone

(505) 846-7377

NPI assigned

Oct 11, 2006

Last updated

Jan 31, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1417045444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7413 LUELLA ANNE DR NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093935",
            "telephone_number": "505-872-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 BIGGS AVENUE BLDG 939",
            "city": "KIRTLAND AFB",
            "state": "NM",
            "postal_code": "871171908",
            "telephone_number": "505-846-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENA",
        "first_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "ATC, LPTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-287",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CERTIFICATON FOR ATHLETIC TRAINERS",
            "identifier": "020802030",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lesley Dale Pacheco, MSW
• Derick B Palmer, ED.D, LPC, LMHC, NCC
• James Palmer, LICSW
• Michael Jonathan Paston, MD
• John Keith Paul III, DDS
• Monica Pierce-Wysong, MD
• Thomas Powell, MD
• Stephanie M Powers, NP-C
• Bryan Presler, PSYD
• David Allan Quackenbush, DO

• Athletic Trainer in Kirtland AFB, NM
• Providers in Kirtland AFB, NM by specialty
• Athletic Trainer in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.