NPIMap

Organization Active NPI

Foothills Sports Medicine & Orthopaedics Phoenix, LLC

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1457304792
Registry record updated Apr 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5009 Issued in AZ
Legal business name
FOOTHILLS SPORTS MEDICINE & ORTHOPAEDICS PHOENIX, LLC
Practice address
539 E Glendale Ave
Suite 105
Phoenix, AZ 85020-4900
Phone
(602) 241-3145
NPI assigned
May 18, 2006
Last updated
Apr 18, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2022

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

Authorized official

Name
Mrs. Tanja R Snowden
Title
Office Manager
Phone
(602) 241-3145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 5009 AZ Primary

Addresses

Primary practice location

539 E Glendale Ave
Suite 105
Phoenix, AZ 85020-4900

Mailing address

539 E Glendale Ave
Suite 105
Phoenix, AZ 85020-4900
Phone (602) 241-3145

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040520001469 AZ Part B Supplier - Clinic/Group Practice 0446241129 Receives reassigned benefits from 13 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

539 E Glendale Ave
Ste 5
Phoenix, AZ 85020
Phone (602) 241-3145

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650240000000",
    "number": "1457304792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 E GLENDALE AVE",
            "address_2": "SUITE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204900",
            "telephone_number": "602-241-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 E GLENDALE AVE",
            "address_2": "SUITE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204900",
            "telephone_number": "602-241-3145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS SPORTS MEDICINE & ORTHOPAEDICS PHOENIX, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A",
        "authorized_official_last_name": "SNOWDEN",
        "authorized_official_first_name": "TANJA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "602-241-3145",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5009",
            "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 Apr 18, 2022; 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.