Cibola Sports and Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CIBOLA SPORTS AND PHYSICAL THERAPY

Practice address

242 Mountain Rd
Grants, NM 87020-2602

Phone

(505) 876-6030

Fax

(505) 876-6151

NPI assigned

Oct 5, 2015

Last updated

Oct 5, 2015By 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

Michael Todd Rohde, PT, ATCNPI 1831389188

Title

Physical Therapist/Owner

Phone

(505) 876-6030

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 4

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.

• Michael Todd Rohde, PT, ATC, CSCS

  • Physical Therapist
  • Grants, NM
  • NPI 1831389188
  Medicare reassignment NPD Authorized official
• Michael Scott Glade, OTR/L

  • Occupational Therapist
  • Grants, NM
  • NPI 1154332773
  NPD (past)
• Jon C Otero, PT, ATC

  • Physical Therapist
  • Belen, NM
  • NPI 1588671721
  NPD (past)
• Krista Leigh Riebli, D.P.T

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1730511130
  NPD (past)

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1750751632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 MOUNTAIN RD",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202602",
            "telephone_number": "505-876-6030",
            "fax_number": "505-876-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 MOUNTAIN RD",
            "city": "GRANTS",
            "state": "NM",
            "postal_code": "870202602",
            "telephone_number": "505-876-6030",
            "fax_number": "505-876-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIBOLA SPORTS AND PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "ROHDE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "505-876-6030",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ann K Church, MD
• Cibola General Hospital Corporation (Cibola Family Health Center)
• Cibola General Hospital Corporation (Cibola General Hospital)
• Cibola General Hospital Phcy (Cibola General Hospital Pharmacy)
• Cibola Specialty Associates
• Elven Ray Clemons
• Jolene Colburn
• County of Cibola (Cibola County Fire and Emergency Services)
• John David Coyle, LPCC
• James Woodson Crum

• Physical Therapist in Grants, NM
• Providers in Grants, 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 Oct 5, 2015; 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.