Organization Active NPI

Mesa Physical Medicine PLLC

  • Primary Care Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1154774305
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
AP4338 Issued in AZ
Legal business name
MESA PHYSICAL MEDICINE PLLC
Practice address
10207 E Hampton Ave Ste 105
Mesa, AZ 85209-3336
Phone
(480) 354-2008
NPI assigned
Jul 22, 2016
Last updated
Sep 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Authorized official

Name
Dr. Scott Taylor, D.C.NPI 1023381340
Title
Ceo
Phone
(480) 907-1322

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X AP4338 AZ Primary

Addresses

Primary practice location

10207 E Hampton Ave Ste 105
Mesa, AZ 85209-3336

Mailing address

10207 E Hampton Ave Ste 105
Mesa, AZ 85209-3336
Phone (480) 354-2008

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161004000016 AZ Part B Supplier - Clinic/Group Practice 1557659745 Receives reassigned benefits from 7 practitioners
Practice locations: Mesa, AZ; Tempe, AZ

National Provider Directory

National Provider Directory

Locations

10207 E Hampton Ave
Ste 105
Mesa, AZ 85209
Phone (480) 354-2008

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790208000000",
    "number": "1154774305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10207 E HAMPTON AVE STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093336",
            "telephone_number": "480-354-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10207 E HAMPTON AVE STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093336",
            "telephone_number": "480-354-2008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA PHYSICAL MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-22",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "480-907-1322",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "AZ",
            "license": "AP4338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.