NPIMap

Individual provider Active NPI

Juan Carlos Zavala, MASSAGE THERAPIST

  • Contractor
  • Albuquerque, NM
National Provider Identifier
1427323633
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
LMT 3032 Issued in NM
Practice address
230 Adams St SE
S.E.
Albuquerque, NM 87108-2805
Phone
(505) 843-7492
NPI assigned
Mar 21, 2012
Last updated
Mar 21, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X LMT 3032 NM Primary

Addresses

Primary practice location

230 Adams St SE
S.E.
Albuquerque, NM 87108-2805

Mailing address

230 Adams Street
S.E.
Albuquerque, NM 87108
Phone (505) 843-7492

Other names 1

  • Mr. Juan Carlos Zavala Professional name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMT 3032NMMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1427323633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 ADAMS STREET",
            "address_2": "S.E.",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87108",
            "telephone_number": "505-843-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 ADAMS ST SE",
            "address_2": "S.E.",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871082805",
            "telephone_number": "505-843-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVALA",
        "first_name": "JUAN",
        "middle_name": "CARLOS",
        "name_prefix": "Mr.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NM",
            "license": "LMT 3032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "ZAVALA",
            "middle_name": "CARLOS",
            "prefix": "MR.",
            "credential": "MASSAGE THERAPIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Mar 21, 2012; 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.