Reactive Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

REACTIVE PHYSICAL THERAPY

Practice address

722 S Sunset Ave
Roswell, NM 88203-2800

Phone

(503) 349-0332

NPI assigned

Oct 14, 2021

Last updated

Dec 24, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kiersten Lynn, DPTNPI 1700317583

Title

Owner

Phone

(575) 208-8575

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kiersten Lynn, PT

  • Physical Therapist
  • Roswell, NM
  • NPI 1700317583
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1634169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734998400000",
    "number": "1710640024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W 2ND ST",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882012000",
            "telephone_number": "503-349-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 S SUNSET AVE",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882032800",
            "telephone_number": "503-349-0332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REACTIVE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-14",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "KIERSTEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-208-8575",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susanna Rand, LPCC
• Rosaura Rand,, B.A.
• Randy a. Barone, DDS, LLC
• Julie Rasor
• Tammy Lynn Ray, LMT
• Rebel Mary Reavis, FNP-C
• Recovery Services of New Mexico, LLC (MedMark Treatment Centers Roswell)
• Samantha J Reed, LISW
• Travis Reed, DO
• Ileana Reese

• Physical Therapist in Roswell, NM
• Providers in Roswell, NM by specialty
• Physical Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; 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.