Active NPI
Jessica Short
- Physical Therapist
- Mesa, AZ
National Provider Identifier
1043747074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12472
- Practice address
- 844 N Ellsworth Rd
Mesa, AZ 85207-5114 - Phone
- (480) 380-2810
- NPI assigned
- May 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12472 | AZ | Primary |
Addresses
Primary practice location
844 N Ellsworth Rd
Mesa, AZ 85207-5114
Mailing address
844 N Ellsworth Rd
Mesa, AZ 85207-5114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12472 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JWG, Inc | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Mesa, AZ
- NPI 1467599035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495411200000",
"number": "1043747074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "844 N ELLSWORTH RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852075114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "844 N ELLSWORTH RD",
"city": "MESA",
"state": "AZ",
"postal_code": "852075114",
"telephone_number": "480-380-2810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORT",
"first_name": "JESSICA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-05-22",
"last_updated": "2017-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "12472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.