NPIMap

Organization Active NPI

Foothills Sports Medicine & Rehabilitation-Surprise, LLC

  • Physical Therapist
  • Surprise, AZ
National Provider Identifier
1750544623
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FOOTHILLS SPORTS MEDICINE & REHABILITATION-SURPRISE, LLC
Practice address
15543 N Reems Rd
Suite 133
Surprise, AZ 85374
Phone
(480) 706-1161
Fax
(480) 706-7997
NPI assigned
Jul 9, 2008
Last updated
May 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

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

Authorized official

Name
Ms. Tanja Snowden
Title
Executive Assistant
Phone
(480) 706-7716

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Pediatric Physical Therapist 2251P0200X NU
Sports Physical Therapist 2251S0007X NU

Addresses

Primary practice location

15543 N Reems Rd
Suite 133
Surprise, AZ 85374

Mailing address

15543 N Reems Rd
Suite 133
Surprise, AZ 85374
Phone (480) 706-1161

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081023000323 AZ Part B Supplier - Clinic/Group Practice 1658439468 Receives reassigned benefits from 12 practitioners
Practice locations: Surprise, AZ

National Provider Directory

National Provider Directory

Locations

15543 N Reems Rd
Ste 133
Surprise, AZ 85374
Phone (623) 975-5374

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651708800000",
    "number": "1750544623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15543 N REEMS RD",
            "address_2": "SUITE 133",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85374",
            "telephone_number": "480-706-1161",
            "fax_number": "480-706-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15543 N REEMS RD",
            "address_2": "SUITE 133",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "85374",
            "telephone_number": "480-706-1161",
            "fax_number": "480-706-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS SPORTS MEDICINE & REHABILITATION-SURPRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-09",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "SNOWDEN",
        "authorized_official_first_name": "TANJA",
        "authorized_official_title_or_position": "EXECUTIVE ASSISTANT",
        "authorized_official_telephone_number": "480-706-7716",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.