Jessica Medrano, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

013831 Issued in AZ

Practice address

14154 S Denny Blvd
Litchfield Park, AZ 85340-9431

Phone

(623) 537-7500

NPI assigned

Jul 27, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1003425943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18041 W YOUNG ST",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853881617",
            "telephone_number": "623-806-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14154 S DENNY BLVD",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409431",
            "telephone_number": "623-537-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDRANO",
        "first_name": "JESSICA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "013831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Mary McIvor, SLPA
• Kristina D McLaurin, CSFA
• Regina A. McManigell, LAC-22707
• Christine McNeil
• Lynne McTaggart, MSN FNP-C
• Denise Melton
• Melinda Michelle Melvin, RN
• Cary Mendes, PT, DPT
• Erendira E Mendoza Madrigal, RBT
• Gregorio Mercado Jr., PTA

• Physical Therapy Assistant in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Physical Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.