Smith Spine & Orthopaedic Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SMITH SPINE & ORTHOPAEDIC PHYSICAL THERAPY, LLC

Practice address

8126 W Carlota LN
Peoria, AZ 85383-2196

Phone

(602) 540-8708

NPI assigned

Dec 15, 2007

Last updated

Dec 15, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Susan B Wyatt

Title

Owner

Phone

(602) 540-8708

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1197676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197676800000",
    "number": "1578746392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8126 W CARLOTA LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853832196",
            "telephone_number": "602-540-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8126 W CARLOTA LN",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853832196",
            "telephone_number": "602-540-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH SPINE & ORTHOPAEDIC PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-15",
        "last_updated": "2007-12-15",
        "status": "A",
        "authorized_official_last_name": "WYATT",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-540-8708",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Peoria, AZ by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2007; 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.