Active NPI
Leslie Sue Innis, PHYSICAL THERAPIST
- Physical Therapist
- Tempe, AZ
National Provider Identifier
1235270240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5249
- Practice address
- 4515 S McClintock Dr
Suite#118
Tempe, AZ 85282-7376 - Phone
- (505) 270-6545
- NPI assigned
- Feb 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5249 | AZ | Primary |
| Physical Therapist | 225100000X | 164 | NM |
Addresses
Primary practice location
4515 S McClintock Dr
Suite#118
Tempe, AZ 85282-7376
Mailing address
3471 Cerrillos Rd
Trailer # 93
Santa Fe, NM 87507-7235
Phone (505) 270-6545
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5249 | AZ | MD | Physical Therapist |
| 164 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235270240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3471 CERRILLOS RD",
"address_2": "TRAILER # 93",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875077235",
"telephone_number": "505-270-6545"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4515 S MCCLINTOCK DR",
"address_2": "SUITE#118",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852827376",
"telephone_number": "505-270-6545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INNIS",
"first_name": "LESLIE",
"middle_name": "SUE",
"name_prefix": "Ms.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "5249",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "164",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
- Brandy E. Ingram, P.A.-C
- Kelly Ingram, SLP
- Injury Pain Group, LLC
- Inland Empire Mental Health Services
- Inner-Work Counseling
- Inspire Hope Occupational & Physical Therapy PLLC
- Inspired Homecare of Arizona, LLC
- Institutional Pharmacy Solutions
- Integrated Healthcare Mobile Solutions, LLC
- Integrated Interventional Pain Management P.C. (The Beth-El Clinic)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.