Active NPI
Jacqueline Kinley Rea, PT, DPT
- Physical Therapist
- Santa Fe, NM
National Provider Identifier
1710219639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3710
- Practice address
- 333 W Cordova Rd
Suite 100
Santa Fe, NM 87505-1850 - Phone
- (505) 984-9101
- Fax
- (505) 984-8998
- NPI assigned
- Feb 2, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3710 | NM | Primary |
Addresses
Primary practice location
333 W Cordova Rd
Suite 100
Santa Fe, NM 87505-1850
Mailing address
333 W Cordova Rd
Suite 100
Santa Fe, NM 87505-1850
Phone (505) 984-9101
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 |
|---|---|---|---|
| 3710 | NM | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1265068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265068800000",
"number": "1710219639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "333 W CORDOVA RD",
"address_2": "SUITE 100",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875051850",
"telephone_number": "505-984-9101",
"fax_number": "505-984-8998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 W CORDOVA RD",
"address_2": "SUITE 100",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875051850",
"telephone_number": "505-984-9101",
"fax_number": "505-984-8998"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REA",
"first_name": "JACQUELINE",
"middle_name": "KINLEY",
"name_prefix": "Dr.",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-02-02",
"last_updated": "2010-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "3710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.