Individual provider Active NPI

Julie Dewerd, PT OCS

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1609899814
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3602 Issued in NM
Practice address
11719 Menaul Blvd NE
Albuquerque, NM 87112-1790
Phone
(505) 345-8050
Fax
(505) 343-8050
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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 3602 NM Primary

Addresses

Primary practice location

11719 Menaul Blvd NE
Albuquerque, NM 87112-1790

Mailing address

11801 Menaul Blvd NE
Albuquerque, NM 87112-2420
Phone (505) 271-9616

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

LicenseStateTypeSpecialty
3602NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Orthopedic Rehabilitation Institute,Inc Physical Therapist PastSince Nov 26, 2002 Accepting new patients
South Suburban Open MRI of Orland, LLC Past Accepting new patients
Fifty N Fit Inc Physical Therapist PastSince Mar 20, 2019 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1609899814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11801 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871122420",
            "telephone_number": "505-271-9616",
            "fax_number": "505-271-8050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11719 MENAUL BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871121790",
            "telephone_number": "505-345-8050",
            "fax_number": "505-343-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWERD",
        "first_name": "JULIE",
        "credential": "PT OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "3602",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 31, 2011; 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.