NPIMap

Organization Active NPI

Physical Therapy and Rehabilitation Services of Las Cruces, LLC

  • Physical Therapy Clinic/Center
  • Las Cruces, NM
National Provider Identifier
1740733377
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PHYSICAL THERAPY AND REHABILITATION SERVICES OF LAS CRUCES, LLC
Practice address
4151 Camino Coyote
Las Cruces, NM 88011-7096
Phone
(575) 522-0484
NPI assigned
Aug 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Authorized official

Name
Ava M Borde
Title
Coo
Phone
(575) 522-0484

Specialties & licenses 1

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

Addresses

Primary practice location

4151 Camino Coyote
Las Cruces, NM 88011-7096

Mailing address

PO Box 13759
Las Cruces, NM 88013-3759
Phone (575) 522-0484

Other names 1

  • LAS CRUCES COMPREHENSIVE REHABILITATION, INC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170207000445 NM Part B Supplier - Physical/Occupational Therapy Group in Private Practice 7911280573 Receives reassigned benefits from 9 practitioners
Practice locations: Las Cruces, NM

National Provider Directory

National Provider Directory
Tax ID family
Las Cruces Comprehensive Rehabilitation Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4151 Camino Coyote
Ste A
Las Cruces, NM 88011
Phone (575) 522-0484

Practitioners & affiliated clinicians

Practitioners 9

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": "1470009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1740733377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13759",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880133759",
            "telephone_number": "575-522-0484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4151 CAMINO COYOTE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880117096",
            "telephone_number": "575-522-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AND REHABILITATION SERVICES OF LAS CRUCES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-01",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "BORDE",
        "authorized_official_first_name": "AVA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "575-522-0484"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAS CRUCES COMPREHENSIVE REHABILITATION, INC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.