Individual provider Active NPI

Mary Synstad

  • Physical Therapy Assistant
  • Phoenix, AZ
National Provider Identifier
1538449657
Registry record updated Aug 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
0081A Issued in AZ
Practice address
3802 N 91St Ave
Phoenix, AZ 85037-2368
Phone
(623) 772-2200
NPI assigned
Aug 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0081A AZ Primary

Addresses

Primary practice location

3802 N 91St Ave
Phoenix, AZ 85037-2368

Mailing address

12625 W Segovia Dr
Litchfield Park, AZ 85340-5533

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
0081AAZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1313798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313798400000",
    "number": "1538449657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12625 W SEGOVIA DR",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853405533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 N 91ST AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850372368",
            "telephone_number": "623-772-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYNSTAD",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-20",
        "last_updated": "2011-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "0081A",
            "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 Aug 20, 2011; 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.