Individual provider Active NPI

Crystal Lynn Speirs, PTA

  • Physical Therapy Assistant
  • Phoenix, AZ
National Provider Identifier
1245590975
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA9691 Issued in AZ
Practice address
375 E Virginia Ave
Suite B
Phoenix, AZ 85004-1220
Phone
(602) 264-5323
Fax
(602) 264-5302
NPI assigned
May 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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 PTA9691 AZ Primary

Addresses

Primary practice location

375 E Virginia Ave
Suite B
Phoenix, AZ 85004-1220

Mailing address

375 E Virginia Ave
Suite B
Phoenix, AZ 85004-1220
Phone (602) 264-5323

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
PTA9691AZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1245590975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 E VIRGINIA AVE",
            "address_2": "SUITE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041220",
            "telephone_number": "602-264-5323",
            "fax_number": "602-264-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E VIRGINIA AVE",
            "address_2": "SUITE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041220",
            "telephone_number": "602-264-5323",
            "fax_number": "602-264-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEIRS",
        "first_name": "CRYSTAL",
        "middle_name": "LYNN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA9691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.