Active NPI
Larry Coomer Hernandez, PTA
- Physical Therapy Assistant
- Fort Mohave, AZ
National Provider Identifier
1760283345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 014942
- Practice address
- 5330 S Highway 95
Fort Mohave, AZ 86426-9225 - Phone
- (928) 788-2273
- NPI assigned
- Mar 20, 2025
- Last updated
- Mar 20, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 014942 | AZ | Primary |
Addresses
Primary practice location
5330 S Highway 95
Fort Mohave, AZ 86426-9225
Mailing address
533O S Hwy 95
Fort Mohave, AZ 86426
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014942 | AZ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742428800000",
"number": "1760283345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "533O S HWY 95",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "86426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5330 S HIGHWAY 95",
"city": "FORT MOHAVE",
"state": "AZ",
"postal_code": "864269225",
"telephone_number": "928-788-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERNANDEZ",
"first_name": "LARRY",
"middle_name": "COOMER",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-03-20",
"last_updated": "2025-03-20",
"certification_date": "2025-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "014942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Mohave, AZ
- Hanger Prosthetics & Orthotics West Inc (Hanger Clinic)
- Maria Elizabeth Harris, RN
- Polly A Hediger, DC
- Hematology Oncology Associates of North Jersey, LLC (Dr. Mohtaseb Cancer Center and Blood Disorders)
- Richard E Hendrix, MD
- Cara Michelle Hetrick, RN, BSN
- Nathaniel Charles Hollister, MD
- Les Jay Holub, RPH
- Cari Dawn Horne, CSFA
- HPH Homecare, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.