Organization Active NPI

Geriatric PM&R LLC

  • Physical Medicine & Rehabilitation Physician
  • El Paso, TX
National Provider Identifier
1992188403
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
GERIATRIC PM&R LLC
Practice address
329 Vista del Rey Dr
El Paso, TX 79912-4824
Phone
(915) 209-0157
NPI assigned
Jul 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Authorized official

Name
Catherine Wakeham, MD
Title
Owner
Phone
(915) 209-0589

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

329 Vista del Rey Dr
El Paso, TX 79912-4824

Mailing address

PO Box 700390, Dept 0471
Tulsa, OK 74170-0390
Phone (254) 727-9193

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574640000000",
    "number": "1992188403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 700390, DEPT 0471",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741700390",
            "telephone_number": "254-727-9193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 VISTA DEL REY DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799124824",
            "telephone_number": "915-209-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC PM&R LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2019-11-25",
        "status": "A",
        "authorized_official_last_name": "WAKEHAM",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-209-0589",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.