NPIMap

Organization Active NPI

Rainbow'S Promise Therapies, Inc.

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1972679272
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6761 Issued in NM
Legal business name
RAINBOW'S PROMISE THERAPIES, INC.
Practice address
5130 San Francisco Rd NE Ste B
Albuquerque, NM 87109-4618
Phone
(505) 823-2411
Fax
(505) 858-0650
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Authorized official

Name
Thomas Staton, PTNPI 1528355997
Title
Owner, Clinical Director
Phone
(505) 823-2411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 6761 NM Primary

Addresses

Primary practice location

5130 San Francisco Rd NE Ste B
Albuquerque, NM 87109-4618

Mailing address

5130 San Francisco Rd NE Ste B
Albuquerque, NM 87109-4618
Phone (505) 823-2411

Other identifiers 4

IdentifierTypeStateIssuer
695957OtherNMACN
NM00N582OtherNMBCBS
188126500OtherNMACS
26790OtherNMPRESBYTERIAN HEALTH PLAN

Other names 1

  • Bear Canyon Therapy Associates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040501000117 NM Part B Supplier - Clinic/Group Practice 9931197894 Receives reassigned benefits from 3 practitioners
Practice locations: Albuquerque, NM

National Provider Directory

National Provider Directory

Locations

6100 Seagull St NE
Ste 102B
Albuquerque, NM 87109

5130 San Francisco Rd NE
Albuquerque, NM 87109

6100 Seagull St NE
Ste 102
Albuquerque, NM 87109
Phone (505) 823-2411

6100 Seagull St NE
Ste B102
Albuquerque, NM 87109
Phone (505) 823-2411

7007 Wyoming Blvd NE
Ste A2
Albuquerque, NM 87109
Phone (505) 280-7479

5130 San Francisco Rd NE
Ste B
Albuquerque, NM 87109
Phone (505) 823-2411

7007 Wyoming Blvd NE
Ste A1
Albuquerque, NM 87109
Phone (505) 823-2411

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1972679272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 SAN FRANCISCO RD NE STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094618",
            "telephone_number": "505-823-2411",
            "fax_number": "505-858-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 SAN FRANCISCO RD NE STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094618",
            "telephone_number": "505-823-2411",
            "fax_number": "505-858-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAINBOW'S PROMISE THERAPIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "STATON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER, CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "505-823-2411",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "6761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "695957",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "NM00N582",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "188126500",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH PLAN",
            "identifier": "26790",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bear Canyon Therapy Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.