NPIMap

Organization Active NPI

James Park

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1467704957
Registry record updated Oct 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2074 Issued in NM
Legal business name
JAMES PARK
Practice address
6501 Eagle Rock Ave NE
Suite A6
Albuquerque, NM 87113-2478
Phone
(505) 514-2900
NPI assigned
Oct 8, 2012
Last updated
Oct 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2012

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

Authorized official

Name
Dr. James ParkNPI 1255396719
Title
Business Manager
Phone
(505) 514-2900

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 866RX1 NM
Physical Therapist 225100000X 2074 NM Primary

Addresses

Primary practice location

6501 Eagle Rock Ave NE
Suite A6
Albuquerque, NM 87113-2478

Mailing address

6501 Eagle Rock Ave NE
Suite A6
Albuquerque, NM 87113-2478
Phone (505) 514-2900

Other identifiers 2

IdentifierTypeStateIssuer
7645703OtherAETNA
45139024MedicaidNM

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": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349654400000",
    "number": "1467704957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 EAGLE ROCK AVE NE",
            "address_2": "SUITE A6",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132478",
            "telephone_number": "505-514-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 EAGLE ROCK AVE NE",
            "address_2": "SUITE A6",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871132478",
            "telephone_number": "505-514-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2012-10-08",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "505-514-2900",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NM",
            "license": "866RX1",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "2074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7645703",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45139024",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.