Active NPI
Jonathan Plank, A.T.
- Athletic Trainer
- Las Cruces, NM
National Provider Identifier
1760890487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 486
- Practice address
- 2404 S Locust St Ste 5
Las Cruces, NM 88001-5789 - Phone
- (575) 522-0766
- NPI assigned
- Jul 25, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 486 | NM | Primary |
Addresses
Primary practice location
2404 S Locust St Ste 5
Las Cruces, NM 88001-5789
Mailing address
2404 S. Locust Ste. 5
Southwest Sport and Spine Center, Inc
Las Cruces, NM 88001-9998
Phone (575) 522-0766
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 486 | NM | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Sport and Spine Center Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Las Cruces, NM
- NPI 1164475208
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406246400000",
"number": "1760890487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2404 S. LOCUST STE. 5",
"address_2": "SOUTHWEST SPORT AND SPINE CENTER, INC",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880019998",
"telephone_number": "575-522-0766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2404 S LOCUST ST STE 5",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880015789",
"telephone_number": "575-522-0766"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PLANK",
"first_name": "JONATHAN",
"credential": "A.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-25",
"last_updated": "2014-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NM",
"license": "486",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.