Blue Skyes Wellness Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BLUE SKYES WELLNESS CENTER LLC

Practice address

625 N Gilbert Rd
Suite 103
Gilbert, AZ 85234-3398

Phone

(602) 845-9748

NPI assigned

Nov 13, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Davonna Marie Willis, ATC, LMT

Title

Owner

Phone

(602) 845-9748

Specialties & licenses 1

Addresses

Other names 1

• Blue Skyes Wellness Doing business as

Locations

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

{
    "created_epoch": "1478995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478995200000",
    "number": "1548702111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N GILBERT RD",
            "address_2": "SUITE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343398",
            "telephone_number": "602-845-9748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N GILBERT RD",
            "address_2": "SUITE 103",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343398",
            "telephone_number": "602-845-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKYES WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-13",
        "last_updated": "2016-11-13",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "DAVONNA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-845-9748",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "ATC, LMT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Skyes Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapy Clinic/Center in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2016; 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.