Individual provider Active NPI

Jesse Hatfield

  • Physical Therapy Assistant
  • Safford, AZ
National Provider Identifier
1184492209
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-014287 Issued in AZ
Practice address
2290 W 16TH St
Safford, AZ 85546-4081
Phone
(928) 348-4220
NPI assigned
Dec 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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 PTA-014287 AZ Primary

Addresses

Primary practice location

2290 W 16TH St
Safford, AZ 85546-4081

Mailing address

6738 S US Highway 191
Safford, AZ 85546-8412
Phone (928) 432-1872

Other names 1

  • Jesse Stone Former name

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
PTA-014287AZMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Roadrunner Rehab Incorporated CurrentSince Dec 24, 2023 Accepting new patients

Locations

2290 W 16th St
Safford, AZ 85546
Phone (928) 348-4220

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1702857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1184492209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6738 S US HIGHWAY 191",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855468412",
            "telephone_number": "928-432-1872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2290 W 16TH ST",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464081",
            "telephone_number": "928-348-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "JESSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-18",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-014287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSE",
            "last_name": "STONE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Safford, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; 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.