Joan Mactough, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11606 Issued in AZ

Practice address

8240 W Cactus Rd
Peoria, AZ 85381-5231

Phone

(623) 878-9696

Fax

(623) 776-0668

NPI assigned

Jun 10, 2015

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

Other identifiers 1

Other names 1

• Joan Jordan Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1376924811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8240 W. CACTUS RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85381",
            "telephone_number": "623-878-9696",
            "fax_number": "623-776-0668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8240 W CACTUS RD",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815231",
            "telephone_number": "623-878-9696",
            "fax_number": "623-776-0668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACTOUGH",
        "first_name": "JOAN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-10",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026411",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "JORDAN",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karyn A Mackenzie Fajardo, LCSW, LICSW
• Brandon J Mackey, D.O.
• Christopher G Mackey, DO
• Vernon Thomas Mackey, D.O.
• Bradly Andrew Macneil, PHD
• Laura D Madden
• Nicole Renee Maddox, DC
• Jacob Maddux, M.D.
• Zoe Madsen
• Magellan Health Services of Arizona, Inc.

• Physical Therapist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; 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.