Active NPI
Jovanna Maldonado
- Massage Therapist
- Rio Rancho, NM
National Provider Identifier
1518724327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MT2024-0010
- Practice address
- 1005 21St St SE
Rio Rancho, NM 87124-4030 - Phone
- (720) 404-3875
- NPI assigned
- Feb 28, 2024
- Last updated
- Apr 22, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MT2024-0010 | NM | Primary |
Addresses
Primary practice location
1005 21St St SE
Rio Rancho, NM 87124-4030
Mailing address
2130 Coba Rd SE
Rio Rancho, NM 87124-8916
Phone (720) 404-3875
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 |
|---|---|---|---|
| MT2024-0010 | NM | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wfa LLC | Massage Therapist | Current | Accepting new patients |
Locations
1005 21st St SE
Rio Rancho, NM 87124
Phone (505) 302-1492
1005 21st St SE
Ste 4
Rio Rancho, NM 87124
Phone (505) 402-3188
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1518724327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2130 COBA RD SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871248916",
"telephone_number": "720-404-3875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 21ST ST SE",
"city": "RIO RANCHO",
"state": "NM",
"postal_code": "871244030",
"telephone_number": "720-404-3875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALDONADO",
"first_name": "JOVANNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-28",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "MT2024-0010",
"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 Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.