Active NPI
Jon J George, CMTPT
- Specialist
- Albuquerque, NM
National Provider Identifier
1972650224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 4024
- Practice address
- 4103 Montgomery Blvd NE
Albuquerque, NM 87109-1102 - Phone
- (505) 830-3585
- Fax
- (505) 830-3584
- NPI assigned
- Jan 5, 2007
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 4024 | NM | Primary |
Addresses
Primary practice location
4103 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Mailing address
4103 Montgomery Blvd NE
Albuquerque, NM 87109-1102
Phone (505) 830-3585
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 |
|---|---|---|---|
| 4024 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Myotherapy | 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.
-
- Massage Therapist
- Albuquerque, NM
- NPI 1679725667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972650224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4103 MONTGOMERY BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091102",
"telephone_number": "505-830-3585",
"fax_number": "505-830-3584"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4103 MONTGOMERY BLVD NE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871091102",
"telephone_number": "505-830-3585",
"fax_number": "505-830-3584"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEORGE",
"first_name": "JON",
"middle_name": "J",
"credential": "CMTPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NM",
"license": "4024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.