Active NPI
Nicholas Perez, PTA
- Physical Therapy Assistant
- Globe, AZ
National Provider Identifier
1568268258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA-014958
- Practice address
- 1100 N Broad St Ste a
Globe, AZ 85501-2700 - Phone
- (928) 961-1345
- NPI assigned
- Feb 22, 2025
- Last updated
- Feb 22, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA-014958 | AZ | Primary |
Addresses
Primary practice location
1100 N Broad St Ste a
Globe, AZ 85501-2700
Mailing address
840 S Highland Dr
Globe, AZ 85501-1991
Phone (928) 363-0826
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
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-014958 | AZ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740182400000",
"number": "1568268258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 S HIGHLAND DR",
"city": "GLOBE",
"state": "AZ",
"postal_code": "855011991",
"telephone_number": "928-363-0826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 N BROAD ST STE A",
"city": "GLOBE",
"state": "AZ",
"postal_code": "855012700",
"telephone_number": "928-961-1345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "NICHOLAS",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-22",
"last_updated": "2025-02-22",
"certification_date": "2025-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "PTA-014958",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Globe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.