Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Justin R Ennis

Individual provider Sports Medicine (Emergency Medicine) Physician · NPI 1023527314

Justin R Ennis is a Sports Medicine (Emergency Medicine) Physician in Portales, New Mexico. Licensed in New Mexico. Registered with an NPI since 2017.

Licensed in
NM
In the registry since
2017

Practice location Address checks out

1500 S Avenue K
Portales, NM 88130-7400
Phone: (760) 525-2087
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Emergency Medicine) Physician (primary) Taxonomy 207PS0010X · Licence 720 (NM)

Record details

NPI number1023527314
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 29, 2017
Last updated in NPPESSeptember 29, 2017