Active NPI
MDR Physical Therapy Inc
- Physical Therapist
- Tucson, AZ
National Provider Identifier
1528280146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4064
- Legal business name
- MDR PHYSICAL THERAPY INC
- Practice address
- 1777 W St Marys Rd
Tucson, AZ 85745 - Phone
- (520) 884-9819
- Fax
- (520) 884-0175
- NPI assigned
- May 3, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mark Douglas Roberts, P.T.
- Title
- Owner Manager
- Phone
- (520) 884-9819
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4064 | AZ | Primary |
Addresses
Primary practice location
1777 W St Marys Rd
Tucson, AZ 85745
Mailing address
1777 W St Marys Rd
Tucson, AZ 85745
Phone (520) 884-9819
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2Z2979 | Other | AZ | HEALTHNET PROVIDER ID |
| AZ0460510 | Other | AZ | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1528280146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1777 W ST MARYS RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85745",
"telephone_number": "520-884-9819",
"fax_number": "520-884-0175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1777 W ST MARYS RD",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85745",
"telephone_number": "520-884-9819",
"fax_number": "520-884-0175"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MDR PHYSICAL THERAPY INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ROBERTS",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "DOUGLAS",
"authorized_official_title_or_position": "OWNER MANAGER",
"authorized_official_telephone_number": "520-884-9819",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "P.T."
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "4064",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET PROVIDER ID",
"identifier": "2Z2979",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "AZ0460510",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
- MD Acute, PC
- MD Anesthesia PLLC
- MD Cares at Oro Valley LLC (AmeriCare Tucson)
- MD House Calls, PLLC
- MD NP Adult Medicine LLC
- MDR Physical Therapy Inc. (Agility Spine and Sports PT)
- MDR Physical Therapy, Inc (Agility Spine and Sports Physical Therapy)
- Mdvip365 (Priority Medical Group)
- Kallie Meade, PT, DPT
- Shayse Meade, RN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.