Jamie N Kamon-Brancazio, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6192 Issued in AZ

Practice address

1695 Mesquite Ave
Suite 106
Lake Havasu City, AZ 86403-5678

Phone

(928) 680-2639

Fax

(928) 680-2626

NPI assigned

Apr 23, 2007

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)

Enrolled

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1760600183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3181 LONGVIEW DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864069046",
            "telephone_number": "928-453-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 MESQUITE AVE",
            "address_2": "SUITE 106",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035678",
            "telephone_number": "928-680-2639",
            "fax_number": "928-680-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMON-BRANCAZIO",
        "first_name": "JAMIE",
        "middle_name": "N",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Daryl John Kallenbach, CNA
• Carrie Jean Kane, LPC
• Mirta I Kaperonis, LCSW
• Vasilios W Kaperonis, M.D.
• Katalin H Boleratzky MD Inc
• Ashutosh Kaushesh, D.D.S.

• Physical Therapist in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; 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.