Individual provider Active NPI

Jessica Collins

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1720420193
Registry record updated Apr 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10344 Issued in AZ
Practice address
5977 E Grant Rd
Suite 101
Tucson, AZ 85712-2341
Phone
(520) 822-8640
Fax
(520) 822-8641
NPI assigned
Jul 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 12436-24 WI
Physical Therapist 225100000X 10344 AZ Primary

Addresses

Primary practice location

5977 E Grant Rd
Suite 101
Tucson, AZ 85712-2341

Mailing address

PO Box 6570
Peoria, AZ 85385-6570
Phone (623) 398-8072

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
10344AZMDPhysical Therapist
12436-24WIMDOrthopedic Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1720420193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6570",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853856570",
            "telephone_number": "623-398-8072",
            "fax_number": "623-398-8235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5977 E GRANT RD",
            "address_2": "SUITE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857122341",
            "telephone_number": "520-822-8640",
            "fax_number": "520-822-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-25",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WI",
            "license": "12436-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; 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.