Organization Active NPI

Mountain Kidz Therapy PLLC

  • Physical Therapy Clinic/Center
  • Flagstaff, AZ
National Provider Identifier
1124640131
Registry record updated May 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
MOUNTAIN KIDZ THERAPY PLLC
Practice address
2861 W Hare Dr
Flagstaff, AZ 86001-2584
Phone
(520) 275-2935
NPI assigned
May 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2020

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

Authorized official

Name
Erin Martinez, PT, DPT
Title
PT
Phone
(520) 275-2935

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

2861 W Hare Dr
Flagstaff, AZ 86001-2584

Mailing address

2861 W Hare Dr
Flagstaff, AZ 86001-2584
Phone (520) 275-2935

National Provider Directory

National Provider Directory

Locations

399 S Malpais Ln
Flagstaff, AZ 86001

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1124640131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2861 W HARE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012584",
            "telephone_number": "520-275-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2861 W HARE DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860012584",
            "telephone_number": "520-275-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN KIDZ THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "520-275-2935",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "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 May 13, 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.

Verify at the official NPI Registry.