Miriam Berenice Rendon Zavala, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

013789 Issued in AZ

Practice address

6550 E 2ND St Ste B
Prescott Valley, AZ 86314-3523

Phone

(928) 777-1932

NPI assigned

Sep 10, 2018

Last updated

Sep 10, 2018By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1700369386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 W EDGEMONT AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850352212",
            "telephone_number": "480-386-2166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6550 E 2ND ST STE B",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863143523",
            "telephone_number": "928-777-1932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "813 Cove Pkwy Ste 103",
            "address_purpose": "LOCATION",
            "city": "Cottonwood",
            "state": "AZ",
            "postal_code": "863264663",
            "country_code": "US",
            "telephone_number": "928-634-2843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RENDON ZAVALA",
        "first_name": "MIRIAM",
        "middle_name": "BERENICE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "013789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Physical Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.