Jessica Song

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-32121 Issued in AZ

Practice address

1828 E Florence Blvd Ste 102
Casa Grande, AZ 85122-4783

Phone

(502) 510-0360

NPI assigned

Aug 8, 2022

Last updated

Aug 11, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BHSM Rehabilitation LLCGroup PAC ID 2062773138, 450 clinicians

Ati Holdings of Arizona LLCGroup PAC ID 2466732862, 223 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Ati Holdings of Arizona, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1871570309
  Medicare reassignment Care Compare group NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Buckeye, AZ
  • NPI 1467129684
  Medicare reassignment Care Compare group
• Foothills Sports Medicine & Rehabilitation, LLC

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1558318170
  Medicare reassignment NPD
• Country Oaks

  • Assisted Living Facility
  • Mesa, AZ
  • NPI 1427914423
  NPD Authorized official
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Bullhead City, AZ
  • NPI 1093681033
  NPD
• BHSM Rehabilitation, LLC

  • Physical Therapy Clinic/Center
  • Glendale, AZ
  • NPI 1235654237
  NPD
• BHSM Rehabilitation, LLC

  dba Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Gilbert, AZ
  • NPI 1497271431
  NPD
• Foothills Sports Medicine & Rehabilitation, LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1073224267
  NPD

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1326776477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23374 W YUMA RD STE 104",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853263120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 E FLORENCE BLVD STE 102",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224783",
            "telephone_number": "502-510-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "JeSong@banner-ptrehab.com",
            "affiliation": "N",
            "address_1": "23374 W Yuma Rd Ste 104",
            "city": "Buckeye",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853263120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Smiths Food & Drug Centers Inc (Frys Food and Drug)
• Smiths Food & Drug Centers Inc (Frys Food and Drug)
• Grace SL Snyder, NP
• Camelia Soliman, MD
• Jennifer Son
• Ranjit Kumar Sood, MD
• Maria Antonieta Sorensen, M. C.
• Rebecca Sorensen, COTA/L
• Lori Ann Soteros, F.N.P.
• Aristeo Hernandez Soto, DC

• Physical Therapist in Casa Grande, AZ
• Providers in Casa Grande, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.