Active NPI
Luis Rey Leyva
- Occupational Therapy Assistant
- Tucumcari, NM
National Provider Identifier
1457424111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1989
- Practice address
- 1107 South 11TH St
Tucumcari, NM 88401 - Phone
- (505) 461-4344
- Fax
- (505) 461-8033
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1989 | NM | Primary |
Addresses
Primary practice location
1107 South 11TH St
Tucumcari, NM 88401
Mailing address
6314 Quay Road Aj
Tucumcari, NM 88401-9728
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1989 | NM | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457424111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6314 QUAY ROAD AJ",
"city": "TUCUMCARI",
"state": "NM",
"postal_code": "884019728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1107 SOUTH 11TH ST",
"city": "TUCUMCARI",
"state": "NM",
"postal_code": "88401",
"telephone_number": "505-461-4344",
"fax_number": "505-461-8033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEYVA",
"first_name": "LUIS",
"middle_name": "REY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NM",
"license": "1989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucumcari, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.