Individual provider Active NPI

Zachary Johnson-Carlson, PTA

  • Physical Therapy Assistant
  • Las Cruces, NM
National Provider Identifier
1447048830
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PT-2024-0050 Issued in NM
Practice address
2550 Samaritan Dr Ste 101-B
Las Cruces, NM 88001-1170
Phone
(575) 592-2088
Fax
(575) 592-2226
NPI assigned
Apr 28, 2025
Last updated
Apr 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PT-2024-0050 NM Primary

Addresses

Primary practice location

2550 Samaritan Dr Ste 101-B
Las Cruces, NM 88001-1170

Mailing address

2550 Samaritan Dr Ste 101-B
Las Cruces, NM 88001-1170
Phone (575) 592-2088

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
PT-2024-0050NMMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1745798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1447048830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 SAMARITAN DR STE 101-B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011170",
            "telephone_number": "575-592-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 SAMARITAN DR STE 101-B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011170",
            "telephone_number": "575-592-2088",
            "fax_number": "575-592-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-CARLSON",
        "first_name": "ZACHARY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-04-28",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "PT-2024-0050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.