Jordan Powell

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

30725 Issued in AZ

Practice address

1745 W Hunt Hwy # B-103
San Tan Valley, AZ 85143-5215

Phone

(480) 568-4580

NPI assigned

Jul 8, 2019

Last updated

Jul 8, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Experience Physical Therapy LLCGroup PAC ID 1557781903, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Experience Physical Therapy LLC

  • Physical Therapist
  • San Tan Valley, AZ
  • NPI 1447877105
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1992367163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 E COTTON CENTER BLVD STE 18",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850408862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W HUNT HWY # B-103",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851435215",
            "telephone_number": "480-568-4580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "30725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Podiatric First Assist PLC
• Ashley Denae Poletti, PHARM D
• Brooke Ashley Popelas, DO
• Alonzo Juwan Pouges
• Amanda Brea Powell
• Premier Integrated Healthcare PLLC
• Presentmind Counseling, LLC.
• David Preston
• Melanie Price
• Traci Price, NMD

• Physical Therapist in San Tan Valley, AZ
• Providers in San Tan Valley, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.