Active NPI
Mark Anderson
- Physical Therapy Assistant
- Phoenix, AZ
National Provider Identifier
1437444130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- P160981068
- Practice address
- 4720 E Cotton Gin Loop
Ste 140
Phoenix, AZ 85040-4823 - Phone
- (602) 567-9881
- NPI assigned
- Jun 10, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 7344A | AZ | |
| Physical Therapy Assistant | 225200000X | P160981068 | WA | Primary |
Addresses
Primary practice location
4720 E Cotton Gin Loop
Ste 140
Phoenix, AZ 85040-4823
Mailing address
4720 E Cotton Gin Loop
Ste 140
Phoenix, AZ 85040-4823
Phone (602) 567-9881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7344A | AZ | MD | Physical Therapy Assistant |
| P160981068 | WA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Supplemental Healthcare | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Hospital Unit
- Phoenix, AZ
- NPI 1508004219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595894400000",
"number": "1437444130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4720 E COTTON GIN LOOP",
"address_2": "STE 140",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850404823",
"telephone_number": "602-567-9881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4720 E COTTON GIN LOOP",
"address_2": "STE 140",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850404823",
"telephone_number": "602-567-9881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-10",
"last_updated": "2020-07-28",
"certification_date": "2020-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "7344A",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WA",
"license": "P160981068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.