Active NPI
Geriatric PM&R LLC
- Physical Medicine & Rehabilitation Physician
- El Paso, TX
National Provider Identifier
1992188403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | |||
| Physical Medicine & Rehabilitation Physician | 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 DirectoryNPI 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.