Individual provider Active NPI

Crystal Miriah Vendrell, DPT

  • Orthopedic Physical Therapist
  • Gilbert, AZ
National Provider Identifier
1962673269
Registry record updated Nov 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
7915 Issued in AZ
Practice address
3921 E Baseline Rd
Ste 108
Gilbert, AZ 85234-2727
Phone
(480) 503-2373
Fax
(480) 503-2375
NPI assigned
Mar 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 7915 AZ Primary

Addresses

Primary practice location

3921 E Baseline Rd
Ste 108
Gilbert, AZ 85234-2727

Mailing address

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224-5225
Phone (480) 821-1997

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7915AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
WS Perry LLC Orthopedic Past Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients
BHSM Rehabilitation, LLC Past Accepting new patients
360 Physical Therapy LLC Past Accepting new patients
360 Physical Therapy LLC Physical Therapist Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1205452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226966400000",
    "number": "1962673269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD",
            "address_2": "STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245225",
            "telephone_number": "480-821-1997",
            "fax_number": "480-821-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 E BASELINE RD",
            "address_2": "STE 108",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342727",
            "telephone_number": "480-503-2373",
            "fax_number": "480-503-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENDRELL",
        "first_name": "CRYSTAL",
        "middle_name": "MIRIAH",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-14",
        "last_updated": "2008-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "7915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; 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.