Foothills Sports Medicine & Physical Therapy - Red Mountain LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - RED MOUNTAIN LLC

Practice address

1066 N Power Rd Ste 104-105
Mesa, AZ 85205-5709

Phone

(480) 481-2244

NPI assigned

May 24, 2018

Organization subpart

No

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

Authorized official

Name

Michael Basten

Title

Owner

Phone

(480) 689-5515

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527120000000",
    "number": "1053802199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15410 S MOUNTAIN PKWY STE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446691",
            "telephone_number": "480-706-1161",
            "fax_number": "480-706-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1066 N POWER RD STE 104-105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852055709",
            "telephone_number": "480-481-2244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - RED MOUNTAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2018-05-24",
        "status": "A",
        "authorized_official_last_name": "BASTEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-689-5515"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Fong, SLPA
• Carrie E Fontaine, P.A.
• Laura Fontaine, MS, EDS, LISAC, LPC
• Foothills Psychiatric Services PLLC
• Foothills Sports Medicine & Physical Therapy - North Mesa LLC
• Foothills Sports Medicine & Rehabilitation - East Valley Inc
• Foothills Sports Medicine & Rehabilitation, LLC
• Gabrielle Foppe
• Jennifer Lavonne Forbes, D.C.
• Lauren Faith Forbes

• All providers in Mesa, AZ
• Physical Therapy Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; 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.