Foothills Sports Medicine & Physical Therapy - North Mesa LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - NORTH MESA LLC

Practice address

2835 E Brown Rd Ste 101
Mesa, AZ 85213-5470

Phone

(480) 807-6644

NPI assigned

Feb 13, 2020

Last updated

Feb 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Basten

Title

Owner

Phone

(480) 689-5515

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1790318137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15410 S MOUNTAIN PKWY STE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446691",
            "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": "2835 E BROWN RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852135470",
            "telephone_number": "480-807-6644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS SPORTS MEDICINE & PHYSICAL THERAPY - NORTH MESA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "BASTEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-689-5515"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yury Fomin, MD
• Alice Fong, SLPA
• Carrie E Fontaine, P.A.
• Laura Fontaine, MS, EDS, LISAC, LPC
• Foothills Psychiatric Services PLLC
• Foothills Sports Medicine & Physical Therapy - Red Mountain LLC
• Foothills Sports Medicine & Rehabilitation - East Valley Inc (Foothills Sports Medicine & Rehabilitation - Gilbert-Mesa)
• Foothills Sports Medicine & Rehabilitation, LLC
• Gabrielle Foppe
• Jennifer Lavonne Forbes, D.C.

• Physical Therapy Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physical Therapy Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.