NPIMap

Organization Active NPI

New Mexico Physical Therapists Inc

Doing business as VibrantCare Rehabilitation

  • Physical Therapy Clinic/Center
  • Albuquerque, NM
National Provider Identifier
1689670101
Registry record updated Nov 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NEW MEXICO PHYSICAL THERAPISTS INC
Doing business as
VibrantCare Rehabilitation
Practice address
4824 McMahon Blvd NW
Ste 101
Albuquerque, NM 87114-5412
Phone
(505) 897-3575
Fax
(505) 897-3726
NPI assigned
Jun 21, 2005
Last updated
Nov 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2023

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

Authorized official

Name
Mr. David Smith
Title
Ceo
Phone
(916) 782-1212

Specialties & licenses 1

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

Addresses

Primary practice location

4824 McMahon Blvd NW
Ste 101
Albuquerque, NM 87114-5412

Mailing address

PO Box 840255
Los Angeles, CA 90084-0255
Phone (916) 789-8115

Other names 1

  • VibrantCare Rehabilitation Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050215001080 NM Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2466441944 Practice locations: Albuquerque, NM

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689670101. Details of each certification follow.

  • CCN 326509 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 326509

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Vibrantcare Rehabilitation
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Feb 8, 1984
Last certification
Dec 18, 2018
Ownership / control type
Proprietary
Facility address
4824 McMahon Blvd NW Ste #101
Albuquerque, NM 87114

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
NM Physical Therapists5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1689670101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840255",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900840255",
            "telephone_number": "916-789-8115",
            "fax_number": "916-773-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4824 MCMAHON BLVD NW",
            "address_2": "STE 101",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871145412",
            "telephone_number": "505-897-3575",
            "fax_number": "505-897-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO PHYSICAL THERAPISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-782-1212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NM",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VibrantCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VibrantCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.