NPIMap

Organization Active NPI

San Juan River Rehabilitation LLC

  • Massage Therapist
  • Pagosa Springs, CO
National Provider Identifier
1437418316
Registry record updated May 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
7499 Issued in CO
Legal business name
SAN JUAN RIVER REHABILITATION LLC
Practice address
250 Hot Springs Blvd
Pagosa Springs, CO 81147-4002
Phone
(505) 947-0112
NPI assigned
May 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2012

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

Authorized official

Name
Mr. David William Dolan, LMTNPI 1205950292
Title
Owner
Phone
(505) 947-0112

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 7499 CO Primary

Addresses

Primary practice location

250 Hot Springs Blvd
Pagosa Springs, CO 81147-4002

Mailing address

PO Box 2462
Pagosa Springs, CO 81147-2462
Phone (505) 947-0112

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1336694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336694400000",
    "number": "1437418316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2462",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811472462",
            "telephone_number": "505-947-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 HOT SPRINGS BLVD",
            "city": "PAGOSA SPRINGS",
            "state": "CO",
            "postal_code": "811474002",
            "telephone_number": "505-947-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN RIVER REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-11",
        "last_updated": "2012-05-11",
        "status": "A",
        "authorized_official_last_name": "DOLAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-947-0112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "7499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pagosa Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.