NPIMap

Organization Active NPI

Southwest Physical & Sports Therapy, LTD

  • Physical Therapist
  • Las Vegas, NM
National Provider Identifier
1447268958
Registry record updated Feb 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6614 Issued in NM
Legal business name
SOUTHWEST PHYSICAL & SPORTS THERAPY, LTD
Practice address
2513 Ridge Runner Rd
Las Vegas, NM 87701-4972
Phone
(505) 425-1117
Fax
(505) 454-7810
NPI assigned
Aug 3, 2006
Last updated
Feb 6, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2012

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

Authorized official

Name
Ms. Carolyn Stoklosa, PTNPI 1952319345
Title
Owner/President
Phone
(505) 425-1117

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6614 NM Primary

Addresses

Primary practice location

2513 Ridge Runner Rd
Las Vegas, NM 87701-4972

Mailing address

2513 Ridge Runner Rd
Las Vegas, NM 87701-4972
Phone (505) 425-1117

Other identifiers 2

IdentifierTypeStateIssuer
201079769OtherNMPRESBYTERIAN HEALTH
Q0423MedicaidNM

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328486400000",
    "number": "1447268958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2513 RIDGE RUNNER RD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014972",
            "telephone_number": "505-425-1117",
            "fax_number": "505-454-7810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2513 RIDGE RUNNER RD",
            "city": "LAS VEGAS",
            "state": "NM",
            "postal_code": "877014972",
            "telephone_number": "505-425-1117",
            "fax_number": "505-454-7810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PHYSICAL & SPORTS THERAPY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-02-06",
        "status": "A",
        "authorized_official_last_name": "STOKLOSA",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "505-425-1117",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "6614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH",
            "identifier": "201079769",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q0423",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 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.