NPIMap

Organization Active NPI

Monty Owen Physical Therapy, LLC

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1396100707
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2989 Issued in AZ
Legal business name
MONTY OWEN PHYSICAL THERAPY, LLC
Practice address
4323 E Broadway Rd Ste 106
Mesa, AZ 85206-3506
Phone
(480) 854-9833
Fax
(480) 854-9834
NPI assigned
Dec 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Authorized official

Name
Mr. Monty A Owen, PTNPI 1609948090
Title
Owner
Phone
(480) 854-9833

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 2989 AZ Primary

Addresses

Primary practice location

4323 E Broadway Rd Ste 106
Mesa, AZ 85206-3506

Mailing address

4323 E Broadway Rd Ste 106
Mesa, AZ 85206-3506
Phone (480) 854-9833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160407000587 AZ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2567760572 Receives reassigned benefits from 2 practitioners
Practice locations: Mesa, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451952000000",
    "number": "1396100707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4323 E BROADWAY RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063506",
            "telephone_number": "480-854-9833",
            "fax_number": "480-854-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4323 E BROADWAY RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063506",
            "telephone_number": "480-854-9833",
            "fax_number": "480-854-9834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTY OWEN PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-30",
        "last_updated": "2016-01-05",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "MONTY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-854-9833",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "2989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.