Individual provider Active NPI

Christina Ann Tice, PTA

  • Physical Therapy Assistant
  • Litchfield Park, AZ
National Provider Identifier
1770922411
Registry record updated Jun 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
8919A Issued in AZ
Practice address
14260 S Denny Blvd
Litchfield Park, AZ 85340-9448
Phone
(623) 537-7400
NPI assigned
Jun 16, 2013
Last updated
Jun 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 8919A AZ Primary
Physical Therapy Assistant 225200000X 9794 CA

Addresses

Primary practice location

14260 S Denny Blvd
Litchfield Park, AZ 85340-9448

Mailing address

16903 W Marconi Ave
Surprise, AZ 85388-1509
Phone (808) 291-0656

Other names 1

  • Christina Ann Mayne Former name

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

LicenseStateTypeSpecialty
8919AAZMDPhysical Therapy Assistant
9794CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1371340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371340800000",
    "number": "1770922411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16903 W MARCONI AVE",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853881509",
            "telephone_number": "808-291-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14260 S DENNY BLVD",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853409448",
            "telephone_number": "623-537-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "CHRISTINA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-16",
        "last_updated": "2013-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "8919A",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "9794",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "MAYNE",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Litchfield Park, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2013; 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.