Bullhead Physical Therapy Center, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5387 Issued in AZ

Legal business name

BULLHEAD PHYSICAL THERAPY CENTER, LLC

Practice address

2767 Silver Creek Rd
Suite B
Bullhead City, AZ 86442-8227

Phone

(928) 704-2194

Fax

(928) 704-2195

NPI assigned

Oct 17, 2012

Organization subpart

No

Name

Mrs. Bhanu Montgomery, P.T.NPI 1861618993

Title

Physical Therapist

Phone

(928) 234-1193

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bhanu Montgomery, P.T.

  • Physical Therapist
  • Bullhead City, AZ
  • NPI 1861618993

  AZ

  Medicare reassignment NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 17, 2012.

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1861745671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 SILVER CREEK RD",
            "address_2": "SUITE B",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428227",
            "telephone_number": "928-704-2194",
            "fax_number": "928-704-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2767 SILVER CREEK RD",
            "address_2": "SUITE B",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428227",
            "telephone_number": "928-704-2194",
            "fax_number": "928-704-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLHEAD PHYSICAL THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "BHANU",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "928-234-1193",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "AZ",
            "license": "5387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bullhead City Hospital Corporation
• Bullhead City Hospital Corporation
• Bullhead City Hospital Corporation
• Bullhead City Senior Living, LLC
• Bullhead Family Medical LLC
• Bullhead Primary Care, LLC
• Bullhead Urgent Care Corp
• Jonathan Burch, M.A., L.P.C.
• Kerry D Burgess, DMD
• Jennifer Diane Burns

• All providers in Bullhead City, AZ
• Physical Therapy Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.