Individual provider Active NPI

John D. Patrick, D.C.

  • Sports Physician Chiropractor
  • Las Cruces, NM
National Provider Identifier
1932147105
Registry record updated Apr 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
1140 Issued in NM
Practice address
3850 E Lohman Ave
Ste 100
Las Cruces, NM 88011-8288
Phone
(575) 521-0793
Fax
(575) 532-7172
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 1140 NM Primary

Addresses

Primary practice location

3850 E Lohman Ave
Ste 100
Las Cruces, NM 88011-8288

Mailing address

3850 E Lohman Ave
Ste 100
Las Cruces, NM 88011-8288
Phone (575) 521-0793

Other identifiers 1

IdentifierTypeStateIssuer
K-219OtherNMBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050217000749 NM Practitioner - Chiropractic 8527010594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Precure Chiropractic Clinic PCGroup PAC ID 2062446875, 4 clinicians

Practice addresses (Care Compare)

2001 10TH St
Alamogordo, NM 88310-4904
Phone (575) 434-1455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1140NMMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Precure Chiropractic Clinic, P.C. CurrentSince Jan 2, 2016 Accepting new patients
May Chiropractic Clinic P C Past Accepting new patients
Precure Investments LLC PastSince Jan 2, 2016 Accepting new patients

Locations

2001 10th St
Alamogordo, NM 88310
Phone (505) 434-1455

Organizations & group practices 3

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397606400000",
    "number": "1932147105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 E LOHMAN AVE",
            "address_2": "STE 100",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118288",
            "telephone_number": "575-521-0793",
            "fax_number": "575-532-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 E LOHMAN AVE",
            "address_2": "STE 100",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118288",
            "telephone_number": "575-521-0793",
            "fax_number": "575-532-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "JOHN",
        "middle_name": "D.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2014-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NM",
            "license": "1140",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "K-219",
            "state": "NM"
        }
    ],
    "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 Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.