Jackson Darveaux

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

7540 N 19TH Ave
Phoenix, AZ 85021-7967

Phone

(888) 873-4221

NPI assigned

Feb 3, 2022

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physio Shop Flagstaff LLCGroup PAC ID 7719416304, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Physio Shop Flagstaff LLC

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

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• The Physio Shop LLC

  • Physical Therapy Clinic/Center
  • Flagstaff, AZ
  • NPI 1134524234

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1643846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1669125191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217967",
            "telephone_number": "888-873-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARVEAUX",
        "first_name": "JACKSON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-03",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrell D Wadas MD PC
• Kathleen Darrow, MSED
• Sabina Dart
• Raquel Lyn Dartt, RN
• Katherine Rose Daru, M.D.
• Tamana Darwaiz
• Shereen Darwish
• Dasa Dental PLLC
• Charles C Daschbach, MD
• Dash of Fab Med Spa LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; 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.