Individual provider Active NPI

Jayla Brown

  • Physical Therapy Assistant
  • Sun Lakes, AZ
National Provider Identifier
1104656057
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
014507 Issued in AZ
Practice address
10440 E Riggs Rd Ste 215
Sun Lakes, AZ 85248-7755
Phone
(480) 304-5510
NPI assigned
Aug 6, 2024
Last updated
Aug 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 014507 AZ Primary

Addresses

Primary practice location

10440 E Riggs Rd Ste 215
Sun Lakes, AZ 85248-7755

Mailing address

4420 E Redwood LN
Phoenix, AZ 85048-7030

Other practice location 1

126 S Canyon St
Carlsbad, NM 88220-5733
Phone (575) 628-0503

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

LicenseStateTypeSpecialty
014507AZMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Activerx, Inc. CurrentSince Aug 11, 2024 Accepting new patients
Carlsbad Physical Therapy & Wellness Center, LLC PastSince Jun 1, 2017 Accepting new patients

Locations

10440 E Riggs Rd
Ste 215
Sun Lakes, AZ 85248
Phone (480) 304-5510

Organizations & group practices 2

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": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1104656057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4420 E REDWOOD LN",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10440 E RIGGS RD STE 215",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487755",
            "telephone_number": "480-304-5510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 S Canyon St",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "NM",
            "postal_code": "882205733",
            "country_code": "US",
            "telephone_number": "575-628-0503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JAYLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "014507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Lakes, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2024; 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.