Individual provider Active NPI

Jason Davis, PTA

  • Physical Therapy Assistant
  • Glendale, AZ
National Provider Identifier
1861347528
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-10273 Issued in AZ
Practice address
5462 W Taro LN
Glendale, AZ 85308-4911
Phone
(602) 908-3155
NPI assigned
Feb 27, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X PTA-10273 AZ Primary

Addresses

Primary practice location

5462 W Taro LN
Glendale, AZ 85308-4911

Mailing address

5462 W Taro LN
Glendale, AZ 85308-4911
Phone (602) 908-3155

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

LicenseStateTypeSpecialty
PTA-10273AZMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1772150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1861347528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5462 W TARO LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084911",
            "telephone_number": "602-908-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5462 W TARO LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084911",
            "telephone_number": "602-908-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JASON",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-02-27",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-10273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; 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.