PT Active Care, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PT ACTIVE CARE, PLLC

Practice address

8914 N 91St Ave
Peoria, AZ 85345-8390

Phone

(623) 877-0100

NPI assigned

Nov 8, 2012

Organization subpart

Yes

Parent organization

PEORIA URGENT CAREAs reported in NPPES

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

Authorized official

Name

Dena Hackworth

Title

Clinical Director

Phone

(623) 877-0100

Specialties & licenses 1

Addresses

Part of

Peoria Urgent Care Center LLC

Locations

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

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1396099552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8914 N 91ST AVE",
            "address_2": "100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458390",
            "telephone_number": "623-877-0100",
            "fax_number": "623-298-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8914 N 91ST AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853458390",
            "telephone_number": "623-877-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT ACTIVE CARE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PEORIA URGENT CARE",
        "enumeration_date": "2012-11-08",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "HACKWORTH",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "623-877-0100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Anthony Prost, D.D.S.
• Santisouk Prough, CMT
• Amanda Pruett
• Lauran Taylor Pruitt, PHARMD
• Mimi Pruniski, OTL
• Amy Puckett, RD
• Pure Love Home Care, LLC
• Pyle Family Chiropractic PLLC
• Rafal Pytlik, D.D.S.
• Q Legacy Home Care LLC

• Physical Therapy Clinic/Center in Peoria, AZ
• Providers in Peoria, 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 Nov 8, 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.