Physical Therapy Clinic of Gold Canyon

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

378 Issued in AZ

Legal business name

PHYSICAL THERAPY CLINIC OF GOLD CANYON

Practice address

6410 S Kings Ranch Rd
Suite 2
Gold Canyon, AZ 85118-7352

Phone

(480) 983-2259

Fax

(480) 983-2259

NPI assigned

Aug 23, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Darlene Marie Churchman

Title

Office Manager

Phone

(480) 983-2259

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254441600000",
    "number": "1407049331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD",
            "address_2": "SUITE 2",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187352",
            "telephone_number": "480-983-2259",
            "fax_number": "480-983-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 S KINGS RANCH RD",
            "address_2": "SUITE 2",
            "city": "GOLD CANYON",
            "state": "AZ",
            "postal_code": "851187352",
            "telephone_number": "480-983-2259",
            "fax_number": "480-983-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY CLINIC OF GOLD CANYON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-23",
        "last_updated": "2009-10-02",
        "status": "A",
        "authorized_official_last_name": "CHURCHMAN",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-983-2259",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "AZ0292230",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "670001707",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Ann McMahon, DDS
• Aaron Udell Miller, D.C.
• Linda Carol Newell, M.D.
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• Pharmacy One LLC
• Jacqueline M Potokar, CERTIFIED CARE GIVER
• Jordan Christopher Pozniak, P.T, DPT
• Raley'S Arizona LLC
• RCS Home Care LLC
• Roxanne Rea, PA-C

• Physical Therapist in Gold Canyon, AZ
• Providers in Gold Canyon, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2009; 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.