Foothills Sports Medicine Physical Therapy- Buckeye LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

FOOTHILLS SPORTS MEDICINE PHYSICAL THERAPY- BUCKEYE LLC

Practice address

1300 S Watson Rd Ste 104
Buckeye, AZ 85326-6264

Phone

(480) 706-1161

NPI assigned

Mar 14, 2022

Organization subpart

No

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

Authorized official

Name

Michael L Basten, DPT

Title

Delegated Official/Ceo

Phone

(480) 689-5515

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1811645484",
    "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": "480-689-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 S WATSON RD STE 104",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853266264",
            "telephone_number": "480-706-1161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILLS SPORTS MEDICINE PHYSICAL THERAPY- BUCKEYE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A",
        "authorized_official_last_name": "BASTEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL/CEO",
        "authorized_official_telephone_number": "480-689-5515",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Fergison, P.A.-C.
• Carmela Marfori Fernandez, FNP-C
• Patricia Irene Fiddie
• Tammy Sue Figgins, SLPA
• Karen Ann Fitzgerald, MS, CCC-SLP
• Stacey Forget
• Melanie Fortino
• Darnell Foster
• Meagan Foxx, FP
• FR5 Ventures, LLC

• Physical Therapist in Buckeye, AZ
• Providers in Buckeye, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2022; 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.