Mario R Contreras Jr., BS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT812 Issued in NM

Practice address

701 W Avenue K
Lovington, NM 88260-5599

Phone

(575) 739-2242

NPI assigned

Feb 19, 2019

Last updated

Aug 31, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1649736216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2988",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882022988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W AVENUE K",
            "city": "LOVINGTON",
            "state": "NM",
            "postal_code": "882605599",
            "telephone_number": "575-739-2242"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1815 Wells St",
            "address_purpose": "LOCATION",
            "city": "Las Cruces",
            "state": "NM",
            "postal_code": "880031304",
            "country_code": "US",
            "telephone_number": "575-650-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONTRERAS",
        "first_name": "MARIO",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "BS, LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-19",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NM",
            "license": "AT812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria B Clements
• Candida Ladawn Coburn, MSN, RN, FNP-C
• Maria Coleman, LMHC
• Nina Colvin
• Lucas Isaiah Contreras
• Crystal Coombs, RDN, LD
• Seth Coombs, MD
• Donnie A. Croley, CRNA
• Juditt Cruz, APRN-CNP
• Karen S Cummings, CFNP

• Athletic Trainer in Lovington, NM
• Providers in Lovington, NM by specialty
• Athletic Trainer in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.