Individual provider Active NPI

Grace Guzman Tuazon, PT

  • Physical Therapist
  • Harrison, AR
National Provider Identifier
1891778031
Registry record updated Apr 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT1960 Issued in AR
Practice address
825 N Main St
Ste 7
Harrison, AR 72601-2914
Phone
(870) 743-5573
Fax
(870) 743-5974
NPI assigned
Nov 22, 2005
Last updated
Apr 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT1960 AR Primary

Addresses

Primary practice location

825 N Main St
Ste 7
Harrison, AR 72601-2914

Mailing address

PO Box 841
Harrison, AR 72602-0841
Phone (870) 743-5573

Other identifiers 2

IdentifierTypeStateIssuer
5X132OtherARBLUE CROSS BLUE SHIELD
132441721MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818000977 AR Practitioner - Physical Therapist in Private Practice 9335179308 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Sports Rehabilitation Physical Therapist CurrentSince Mar 6, 2012 Accepting new patients
Spine and Sports Therapy LLC Physical Therapist CurrentSince Mar 21, 2012 Accepting new patients
Orthospine Rehabilitation Past Accepting new patients
Med CHI Professionals, LLC Past Accepting new patients

Locations

105 Passion Play Rd
Ste F
Eureka Springs, AR 72632
Phone (479) 900-0042

1400 Old Bergman Rd
Ste Pt
Harrison, AR 72601

414 N Main St
Harrison, AR 72601

825 N Main St
Ste 7
Harrison, AR 72601

722 Phillips Pl
Huntsville, AR 72740
Phone (479) 420-7846

201 S 19th St
Ste A
Rogers, AR 72758
Phone (479) 372-3700

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460678400000",
    "number": "1891778031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726020841",
            "telephone_number": "870-743-5573",
            "fax_number": "870-743-5974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N MAIN ST",
            "address_2": "STE 7",
            "city": "HARRISON",
            "state": "AR",
            "postal_code": "726012914",
            "telephone_number": "870-743-5573",
            "fax_number": "870-743-5974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUAZON",
        "first_name": "GRACE",
        "middle_name": "GUZMAN",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2016-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT1960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5X132",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132441721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; 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.