Active NPI
Shelley Mazza, PT
- Physical Therapist
- Mesa, AZ
National Provider Identifier
1861273302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8113
- Practice address
- 5151 E Broadway Rd Ste 102
Mesa, AZ 85206-1346 - Phone
- (480) 396-9922
- NPI assigned
- Oct 10, 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 | 8113 | AZ | Primary |
Addresses
Primary practice location
5151 E Broadway Rd Ste 102
Mesa, AZ 85206-1346
Mailing address
1406 E Debbie Dr
San Tan Valley, AZ 85140-4004
Phone (216) 392-4090
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8113 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696896000000",
"number": "1861273302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1406 E DEBBIE DR",
"city": "SAN TAN VALLEY",
"state": "AZ",
"postal_code": "851404004",
"telephone_number": "216-392-4090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5151 E BROADWAY RD STE 102",
"city": "MESA",
"state": "AZ",
"postal_code": "852061346",
"telephone_number": "480-396-9922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZA",
"first_name": "SHELLEY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-10",
"last_updated": "2023-10-10",
"certification_date": "2023-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "8113",
"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 Oct 10, 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.