Clay Robert Densmore, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

30052 Issued in AZ

Practice address

20240 N 78TH Ave
Glendale, AZ 85308-6198

Phone

(480) 386-8964

NPI assigned

Jul 28, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658966400000",
    "number": "1851027155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21155 N 56TH ST APT 3122",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850545556",
            "telephone_number": "440-417-3757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20240 N 78TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086198",
            "telephone_number": "480-386-8964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENSMORE",
        "first_name": "CLAY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "30052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE BOARD OF PHYSICAL THERAPY",
            "identifier": "30052",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Glendale, AZ
• Providers in Glendale, 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 28, 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.