William A Ennist, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

12377A Issued in AZ

Practice address

5125 N 58TH Ave
Glendale, AZ 85301-7453

Phone

(623) 931-5800

NPI assigned

Nov 15, 2017

Last updated

Nov 15, 2017By the provider in NPPES

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

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": "1510704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510704000000",
    "number": "1861905531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38612 N 25TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850860539",
            "telephone_number": "623-363-9198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5125 N 58TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853017453",
            "telephone_number": "623-931-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIST",
        "first_name": "WILLIAM",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-15",
        "last_updated": "2017-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "12377A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Enticare PC
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• Physical Therapy Assistant in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Physical Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2017; 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.