Clay Mitchell, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA-014721 Issued in AZ

Practice address

1175 W Wickenburg Way Ste 3
Wickenburg, AZ 85390-2262

Phone

(928) 668-0108

NPI assigned

Sep 26, 2023

Last updated

Sep 26, 2023By 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)

Enrolled

Practice roles

Locations

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.

• Champion Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Wickenburg, AZ
  • NPI 1487833893
  NPD

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1902685126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 W WICKENBURG WAY STE 3",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853902262",
            "telephone_number": "928-668-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 W WICKENBURG WAY STE 3",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853902262",
            "telephone_number": "928-668-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "CLAY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-014721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wallace B Mendelson, MD
• Mgo Orthopelvic Physical Therapy
• Miller Clinic LTD
• Vance B. Miller, M.D.
• Rachel Childers Minton
• Cristian Moga
• Tammy Ann Monnett
• Hannah Montano, PA-C
• Tanner Miles Moore, DPM
• Patrick Morris, D.C.

• Physical Therapy Assistant in Wickenburg, AZ
• Providers in Wickenburg, 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 Sep 26, 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.

Verify at the official NPI Registry.