Organization Active NPI

Therapy Mobz LLC

  • Physical Therapy Clinic/Center
  • Gallup, NM
National Provider Identifier
1619381175
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
14-00002839 Issued in NM
Legal business name
THERAPY MOBZ LLC
Practice address
106 Boardman Dr
Gallup, NM 87301-4801
Phone
(505) 722-9188
Fax
(505) 926-0910
NPI assigned
Jun 12, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Authorized official

Name
Jeremias Torres II, PT, DPTNPI 1932517786
Title
Credentialing
Phone
(505) 722-9188

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 14-00002839 NM Primary

Addresses

Primary practice location

106 Boardman Dr
Gallup, NM 87301-4801

Mailing address

106 Boardman Dr
Gallup, NM 87301-4801
Phone (505) 722-9188

Other practice location 1

5345 Wyoming Blvd NE Ste 106
Albuquerque, NM 87109-3193
Phone (505) 595-3120

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141113000403 NM Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4789806464 Receives reassigned benefits from 2 practitioners
Practice locations: Albuquerque, NM; Gallup, NM

National Provider Directory

National Provider Directory

Locations

5345 Wyoming Blvd NE
Ste 106
Albuquerque, NM 87109
Phone (505) 595-3120

106 Boardman Dr
Gallup, NM 87301
Phone (505) 722-9188

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700006400000",
    "number": "1619381175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BOARDMAN DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014801",
            "telephone_number": "505-722-9188",
            "fax_number": "505-926-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BOARDMAN DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014801",
            "telephone_number": "505-722-9188",
            "fax_number": "505-926-0910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5345 Wyoming Blvd NE Ste 106",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871093193",
            "country_code": "US",
            "telephone_number": "505-595-3120",
            "fax_number": "505-926-0910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THERAPY MOBZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-12",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A",
        "authorized_official_last_name": "TORRES",
        "authorized_official_first_name": "JEREMIAS",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "505-722-9188",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NM",
            "license": "14-00002839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.