Jordan C Williams, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

10915PT Issued in AZ

Practice address

460 N Switzer Canyon Dr Ste 400
Flagstaff, AZ 86001-4851

Phone

(928) 440-3106

Fax

(928) 438-6702

NPI assigned

May 27, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proof Physical Therapy and Performance LLCGroup PAC ID 2466736400, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Proof Physical Therapy and Performance, LLC

  • Orthopedic Physical Therapist
  • Flagstaff, AZ
  • NPI 1841736618
  Medicare reassignment Care Compare group Authorized official
• Physio Shop Flagstaff LLC

  • Physical Therapy Clinic/Center
  • Flagstaff, AZ
  • NPI 1407674872

  Physical Therapist

  NPD

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1629480512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 N SWITZER CANYON DR STE 400",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014851",
            "telephone_number": "928-440-3106",
            "fax_number": "928-438-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N SWITZER CANYON DR STE 400",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014851",
            "telephone_number": "928-440-3106",
            "fax_number": "928-438-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "JORDAN",
        "middle_name": "C",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-27",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10915PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Jo Wilkins, OTR
• Kathleen E Willard, MD
• Kimberly Williams-Barnes, DDS
• Hailey Roze Williams
• Jacob Williams, DMD
• Phillip Alexander Williams, MD
• Robert Williams, LPC
• Sondra Williams, PA
• Summer T Williams, NP
• Tiahna Williams

• Physical Therapist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.