Flagstaff Physical Therapy PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FLAGSTAFF PHYSICAL THERAPY PC

Practice address

715 N Beaver St
Flagstaff, AZ 86001

Phone

(928) 773-1601

Fax

(928) 773-1603

NPI assigned

Jun 8, 2005

Last updated

May 13, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark Wayne Statham, PTNPI 1922002831

Title

Owner President

Phone

(928) 773-1601

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Mark W Statham, PT

  • Physical Therapist
  • Flagstaff, AZ
  • NPI 1922002831
  Authorized official Same address or phone

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1215931126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-773-1601",
            "fax_number": "928-773-1603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N BEAVER ST",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "86001",
            "telephone_number": "928-773-1601",
            "fax_number": "928-773-1603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSTAFF PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-08",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "STATHAM",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "928-773-1601",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flagstaff OBGYN LLC
• Flagstaff Pain & Treatment Center (Virtuous Pain Centers)
• Flagstaff Pain and Treatment Center
• Flagstaff Pathology Associates (Pathology Associates of Northern AZ)
• Flagstaff Pediatric Dentistry, P.C.
• Flagstaff Primary Care, PC (DBA: Flagstaff Pediatric Care)
• Flagstaff Psychology and Counseling LLC
• Flagstaff Pulmonology PLLC
• Flagstaff Smiles LLC
• Flagstaff Speech Solutions, PLLC

• Physical Therapy Clinic/Center in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physical Therapy Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2008; 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.