Active NPI
Dustie Jo Mares
- Massage Therapist
- Santa Fe, NM
National Provider Identifier
1588131908
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 8840
- Practice address
- 2019 Galisteo St Ste H2
Santa Fe, NM 87505-2106 - Phone
- (505) 557-6140
- NPI assigned
- Oct 24, 2018
- 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 | 8840 | NM | Primary |
Addresses
Primary practice location
2019 Galisteo St Ste H2
Santa Fe, NM 87505-2106
Mailing address
736 Terrace Dr
Las Vegas, NM 87701-4934
Phone (505) 903-3892
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 |
|---|---|---|---|
| 8840 | NM | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern New Mexico Health Care, LLC | Past | Accepting new patients | |
| Age to Age Counseling PC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counselor
- Albuquerque, NM
- NPI 1336178060
-
- Specialist
- Espanola, NM
- NPI 1861535825
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540339200000",
"number": "1588131908",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "736 TERRACE DR",
"city": "LAS VEGAS",
"state": "NM",
"postal_code": "877014934",
"telephone_number": "505-903-3892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2019 GALISTEO ST STE H2",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875052106",
"telephone_number": "505-557-6140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARES",
"first_name": "DUSTIE",
"middle_name": "JO",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-10-24",
"last_updated": "2018-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "NM",
"license": "8840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.