Individual provider Active NPI

Eryn Paetz, DPT

  • Physical Therapist
  • Rio Rancho, NM
National Provider Identifier
1457699381
Registry record updated Jan 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4233 Issued in NM
Practice address
3001 Broadmoor Blvd NE
Rio Rancho, NM 87144-2100
Phone
(505) 228-7701
NPI assigned
Jan 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4233 NM Primary

Addresses

Primary practice location

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144-2100

Mailing address

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144-2100
Phone (505) 228-7701

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
4233NMMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1359331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359331200000",
    "number": "1457699381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 BROADMOOR BLVD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871442100",
            "telephone_number": "505-228-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 BROADMOOR BLVD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871442100",
            "telephone_number": "505-228-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAETZ",
        "first_name": "ERYN",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-28",
        "last_updated": "2013-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2013; 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.