NPIMap

Individual provider Active NPI

Kim Butters, PHYSICAL THERAPIST

  • Physical Therapist
  • Rio Rancho, NM
National Provider Identifier
1811027485
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1217 Issued in NM
Practice address
117 Elm CT SE
Rio Rancho, NM 87124-8213
Phone
(505) 550-4578
Fax
(505) 891-4505
NPI assigned
Mar 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1217 NM Primary

Addresses

Primary practice location

117 Elm CT SE
Rio Rancho, NM 87124-8213

Mailing address

117 Elm CT SE
Rio Rancho, NM 87124-8213
Phone (505) 550-4578

Other identifiers 1

IdentifierTypeStateIssuer
D3914MedicaidNM

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

LicenseStateTypeSpecialty
1217NMMDPeer Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Wholistic Physical Therapy, 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.

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1811027485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELM CT SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871248213",
            "telephone_number": "505-550-4578",
            "fax_number": "505-891-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 ELM CT SE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871248213",
            "telephone_number": "505-550-4578",
            "fax_number": "505-891-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTTERS",
        "first_name": "KIM",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D3914",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Rancho, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.