Active NPI
Irene V Verdeflor
- Physical Therapist
- Roswell, NM
National Provider Identifier
1588909204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-2024-0048
- Practice address
- 613 W 2ND St Ste 1-5
Roswell, NM 88201-4671 - Phone
- (575) 840-3879
- Fax
- (866) 337-2718
- NPI assigned
- Dec 6, 2012
- Last updated
- Feb 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-2024-0048 | NM | Primary |
| Physical Therapy Assistant | 225200000X | 2093639 | TX |
Addresses
Primary practice location
613 W 2ND St Ste 1-5
Roswell, NM 88201-4671
Mailing address
613 W 2ND St Ste 1-5
Roswell, NM 88201-4671
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2093639 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dynamic Rehab Solutions, LLC | Physical Therapist | Current | Accepting new patients |
Locations
613 W 2nd St
Ste 15
Roswell, NM 88201
Phone (575) 840-3879
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": "1354752000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707955200000",
"number": "1588909204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 W 2ND ST STE 1-5",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882014671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 W 2ND ST STE 1-5",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882014671",
"telephone_number": "575-840-3879",
"fax_number": "866-337-2718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERDEFLOR",
"first_name": "IRENE",
"middle_name": "V",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-06",
"last_updated": "2024-02-15",
"certification_date": "2024-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "PT-2024-0048",
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2093639",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.