Individual provider Active NPI

Jennifer V. Baluyut, LPT

  • Pediatric Rehabilitation Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1497944086
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
License
7683 Issued in AZ
Practice address
2601 E Thomas Rd
Suite 120
Phoenix, AZ 85016-8221
Phone
(602) 424-9880
Fax
(602) 445-5210
NPI assigned
Oct 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine Physician 2081P0010X 7683 AZ Primary

Addresses

Primary practice location

2601 E Thomas Rd
Suite 120
Phoenix, AZ 85016-8221

Mailing address

1402 E South Mountain Ave
Phoenix, AZ 85042-7925
Phone (602) 243-4231

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

LicenseStateTypeSpecialty
7683AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1497944086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 E SOUTH MOUNTAIN AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850427925",
            "telephone_number": "602-243-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 E THOMAS RD",
            "address_2": "SUITE 120",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850168221",
            "telephone_number": "602-424-9880",
            "fax_number": "602-445-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALUYUT",
        "first_name": "JENNIFER",
        "middle_name": "V.",
        "name_prefix": "Mrs.",
        "credential": "LPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-18",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": "AZ",
            "license": "7683",
            "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 Oct 18, 2007; 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.