NPIMap

Organization Active NPI

Foothills Sports Medicine & Rehabilitation- Tucson, LLC

Doing business as Proactive Physical Therapy - Marana

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1205921202
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FOOTHILLS SPORTS MEDICINE & REHABILITATION- TUCSON, LLC
Doing business as
Proactive Physical Therapy - Marana
Practice address
7575 W. Twin Peaks Rd
Suite 155
Tucson, AZ 85743
Phone
(520) 744-6445
Fax
(520) 742-5252
NPI assigned
Oct 4, 2006
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Michael Basten, PT
Title
Owner
Phone
(480) 689-5515

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Neurology Physical Therapist 2251N0400X NU

Addresses

Primary practice location

7575 W. Twin Peaks Rd
Suite 155
Tucson, AZ 85743

Mailing address

15410 S Mountain Pkwy Ste 112
Phoenix, AZ 85044-6691
Phone (480) 706-1161

Other identifiers 1

IdentifierTypeStateIssuer
AZ0460080OtherAZBCBS

Other names 1

  • Proactive Physical Therapy - Marana Doing business as

National Provider Directory

National Provider Directory

Locations

1925 W Orange Grove Rd
Ste 204
Tucson, AZ 85704
Phone (520) 297-1550

7407 E 22nd St
Tucson, AZ 85710
Phone (520) 290-1665

8555 N Silverbell Rd
Ste 106
Tucson, AZ 85743
Phone (520) 744-6445

Practitioners & affiliated clinicians

Practitioners 12

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": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1205921202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15410 S MOUNTAIN PKWY STE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446691",
            "telephone_number": "480-706-1161",
            "fax_number": "480-706-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7575 W. TWIN PEAKS RD",
            "address_2": "SUITE 155",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85743",
            "telephone_number": "520-744-6445",
            "fax_number": "520-742-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS SPORTS MEDICINE & REHABILITATION- TUCSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "BASTEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-689-5515",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "AZ0460080",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proactive Physical Therapy - Marana",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Proactive Physical Therapy - Marana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; 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.