Active NPI
Landmark Medical LLC
- Physical Medicine & Rehabilitation Physician
- Scottsdale, AZ
National Provider Identifier
1053829374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 46628
- Legal business name
- LANDMARK MEDICAL LLC
- Practice address
- 10605 N Hayden Rd Ste G110
Scottsdale, AZ 85260-5505 - Phone
- (480) 443-2584
- NPI assigned
- Jan 22, 2018
- Last updated
- Oct 8, 2020
- Organization subpart
- Yes
- Parent organization
- LANDMARK MEDICAL LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Justin D Thompson
- Title
- Manager
- Phone
- (435) 760-5896
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 8503 | AZ | |
| Physical Medicine & Rehabilitation Physician | 208100000X | 46628 | AZ | Primary |
| Pain Medicine Physician | 208VP0000X | 46628 | AZ | |
| Physical Therapist | 225100000X | 12547 | AZ | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Physician Assistant | 363A00000X | 5090 | AZ | |
| Nurse Practitioner | 363L00000X | AP5002 | AZ |
Addresses
Primary practice location
10605 N Hayden Rd Ste G110
Scottsdale, AZ 85260-5505
Mailing address
2340 W Parkside LN Ste H107
Phoenix, AZ 85027-1274
Phone (602) 354-5310
National Provider Directory
National Provider Directory- Tax ID family
- Landmark Medical LLC
- Part of
- Landmark Medical LLC
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Medicine & Rehabilitation Physician
- Anthem, AZ
- NPI 1144738469
-
- Physical Medicine & Rehabilitation Physician
- Chandler, AZ
- NPI 1528665817
-
- Physical Medicine & Rehabilitation Physician
- Mesa, AZ
- NPI 1760089049
-
- Physical Medicine & Rehabilitation Physician
- Phoenix, AZ
- NPI 1962910281
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516579200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1602115200000",
"number": "1053829374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2340 W PARKSIDE LN STE H107",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850271274",
"telephone_number": "602-354-5310",
"fax_number": "480-887-8041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10605 N HAYDEN RD STE G110",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852605505",
"telephone_number": "480-443-2584"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LANDMARK MEDICAL LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "LANDMARK MEDICAL LLC",
"enumeration_date": "2018-01-22",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A",
"authorized_official_last_name": "THOMPSON",
"authorized_official_first_name": "JUSTIN",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "435-760-5896",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "AZ",
"license": "8503",
"primary": false
},
{
"code": "208100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Medicine & Rehabilitation",
"state": "AZ",
"license": "46628",
"primary": true
},
{
"code": "208VP0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pain Medicine, Pain Medicine",
"state": "AZ",
"license": "46628",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "AZ",
"license": "12547",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "AZ",
"license": "5090",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "AZ",
"license": "AP5002",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Scottsdale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.