Audra Genduso, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

Practice address

1800 Old Pecos TRL Ste B
Santa Fe, NM 87505-4787

Phone

(505) 690-6679

NPI assigned

Nov 18, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Audra Genduso Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wellspring Healing

  • Multi-Specialty Clinic/Center
  • Santa Fe, NM
  • NPI 1306343215

  Massage Therapist

  NPD Authorized official
• Blue Lotus Health Essentials, Inc.

  • Acupuncturist
  • Santa Fe, NM
  • NPI 1700117090

  Contractor

  NPD (past)

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1831529445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 GRAYHAWK PL",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875081332",
            "telephone_number": "505-690-6679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 OLD PECOS TRL STE B",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875054787",
            "telephone_number": "505-690-6679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDUSO",
        "first_name": "AUDRA",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-18",
        "last_updated": "2022-03-16",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NM",
            "license": "CMH0216981",
            "primary": false
        },
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NM",
            "license": "4830",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUDRA",
            "last_name": "GENDUSO",
            "credential": "LMT, LMHC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Eric Geddes, BMS
• Geena Tommasi, LCSW, LLC
• Cornelius Jerome Gehred, DDS
• Cynthia Geist, RN
• Kelly Gemmill
• Lauri Genesio, L.M.T.
• Genevieve Williamson MD LLC
• Genie Hobbs LCSW, LLC
• Theresa Michelle Genovese Elliott, MD
• Kaela-Rose Gentile

• Massage Therapist in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Massage Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.