Active NPI
Jessica Queen, DPT
- Physical Therapist
- Mesa, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 5440 E Southern Ave Ste 101
Mesa, AZ 85206-2779 - Phone
- (480) 641-3533
- NPI assigned
- Nov 14, 2023
- Last updated
- Nov 14, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary |
Addresses
Primary practice location
5440 E Southern Ave Ste 101
Mesa, AZ 85206-2779
Mailing address
105 Gettysburg CT
Dittmer, MO 63023-1809
Other practice location 1
440 N Camino Mercado
Casa Grande, AZ 85122-5749
Phone (520) 836-7996
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vibrantcare Outpatient Rehabilitation West Inc | Past | Accepting new patients | |
| Cobalt Rehabilitation Hospital IV | Past | Accepting new patients | |
| Vibrantcare Outpatient Rehabilitation West Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba PAM Health Rehabilitation Hospital of Surprise
- Rehabilitation Hospital
- Surprise, AZ
- NPI 1679954002
-
dba VibrantCare Rehabilitation
- Physical Therapy Clinic/Center
- Phoenix, AZ
- NPI 1114921871
-
dba VibrantCare Outpatient Rehabilitation - Tucson East
- Physical Therapy Clinic/Center
- Tucson, AZ
- NPI 1699779223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1699920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1861266405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 GETTYSBURG CT",
"city": "DITTMER",
"state": "MO",
"postal_code": "630231809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5440 E SOUTHERN AVE STE 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852062779",
"telephone_number": "480-641-3533"
}
],
"practiceLocations": [
{
"address_1": "440 N Camino Mercado",
"address_purpose": "LOCATION",
"city": "Casa Grande",
"state": "AZ",
"postal_code": "851225749",
"country_code": "US",
"telephone_number": "520-836-7996",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "QUEEN",
"first_name": "JESSICA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-14",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.