NPIMap

Organization Active NPI

New Mexico Sports & Physical Therapy

  • Physical Therapy Clinic/Center
  • Santa Fe, NM
National Provider Identifier
1831242999
Registry record updated Jun 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
6292 Issued in NM
Legal business name
NEW MEXICO SPORTS & PHYSICAL THERAPY
Practice address
1631 Hospital Dr
Suite 220
Santa Fe, NM 87505-4728
Phone
(505) 424-0131
Fax
(505) 795-7073
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2017

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

Authorized official

Name
Dino J Pino
Title
Director
Phone
(505) 424-0131

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X
Physical Therapy Clinic/Center 261QP2000X 6292 NM Primary

Addresses

Primary practice location

1631 Hospital Dr
Suite 220
Santa Fe, NM 87505-4728

Mailing address

2954 Rodeo Park Dr. West
Santa Fe, NM 87505-4728
Phone (505) 424-0131

Other identifiers 1

IdentifierTypeStateIssuer
N4536MedicaidNM

National Provider Directory

National Provider Directory

Locations

2954 Rodeo Park Dr W
Santa Fe, NM 87505
Phone (505) 424-0131

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1831242999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2954 RODEO PARK DR. WEST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054728",
            "telephone_number": "505-424-0131",
            "fax_number": "505-795-7032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 HOSPITAL DR",
            "address_2": "SUITE 220",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054728",
            "telephone_number": "505-424-0131",
            "fax_number": "505-795-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW MEXICO SPORTS & PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "PINO",
        "authorized_official_first_name": "DINO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-424-0131"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NM",
            "license": "6292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N4536",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

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