Individual provider Active NPI

Montana Leeann Gia, PT

  • Physical Therapist
  • Flagstaff, AZ
National Provider Identifier
1104571454
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
32214 Issued in AZ
Practice address
906 W University Ave Ste 120
Flagstaff, AZ 86001-7115
Phone
(928) 556-9935
Fax
(928) 774-4277
NPI assigned
Feb 15, 2022
Last updated
Feb 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 32214 AZ Primary

Addresses

Primary practice location

906 W University Ave Ste 120
Flagstaff, AZ 86001-7115

Mailing address

906 W University Ave Ste 120
Flagstaff, AZ 86001-7115
Phone (928) 556-9935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220309001268 AZ Practitioner - Physical Therapist in Private Practice 1355736356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BHSM Rehabilitation LLCGroup PAC ID 2062773138, 450 clinicians

Practice addresses (Care Compare)

2912 N W St
Flagstaff, AZ 86004-1974
Phone (928) 214-7430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
32214AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BHSM Rehabilitation, LLC CurrentSince Mar 28, 2022 Accepting new patients
BHSM Rehabilitation, LLC CurrentSince Mar 28, 2022 Accepting new patients
BHSM Rehabilitation, LLC Current Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients

Locations

2250 Highway 95
Ste B390
Bullhead City, AZ 86442
Phone (928) 610-2001

1301 W University Ave
Flagstaff, AZ 86001
Phone (928) 556-8607

2912 N West St
Flagstaff, AZ 86004
Phone (928) 214-7430

5200 E Cortland Blvd
Ste C1
Flagstaff, AZ 86004
Phone (928) 440-5094

906 W University Ave
Ste 120
Flagstaff, AZ 86001
Phone (928) 556-9935

3507 S Mercy Rd
Ste A
Gilbert, AZ 85297
Phone (480) 926-0404

2120 Airway Ave
Kingman, AZ 86409
Phone (928) 757-1211

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1644883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1104571454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 W UNIVERSITY AVE STE 120",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860017115",
            "telephone_number": "928-556-9935",
            "fax_number": "928-774-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 W UNIVERSITY AVE STE 120",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860017115",
            "telephone_number": "928-556-9935",
            "fax_number": "928-774-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIA",
        "first_name": "MONTANA",
        "middle_name": "LEEANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-15",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "32214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.