Picacho 1, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PICACHO 1, LLC

Practice address

20715 E Ocotillo Rd
Suite 103
Queen Creek, AZ 85142

Phone

(480) 495-6574

Fax

(480) 888-1533

NPI assigned

Nov 7, 2018

Organization subpart

No

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

Authorized official

Name

Stanley Floyd Carr

Title

Owner

Phone

(480) 495-6574

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541548800000",
    "number": "1528536554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20715 E OCOTILLO RD",
            "address_2": "SUITE 103",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85142",
            "telephone_number": "480-495-6574",
            "fax_number": "480-888-1533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20715 E OCOTILLO RD",
            "address_2": "SUITE 103",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85142",
            "telephone_number": "480-495-6574",
            "fax_number": "480-888-1533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICACHO 1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-07",
        "last_updated": "2018-11-07",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "FLOYD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-495-6574"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alisha Marie Peterson
• Elizabeth Amy Pfeiffenberger
• Jeanie Tuanh Pham, PHARMD
• Philippine Family Care Homes LLC
• Physiotherapy Associates Inc
• Kelsey Picha
• Tyson Pickell
• Dylan James Pile
• John Carter Pitman Jr.
• Carey Edward Pittson, GUIDANCE COUNSELOR

• Physical Therapist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; 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.