FIESTA PEDIATRIC THERAPY (NPI# 1508931569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508931569 |
| Entity Type | Organization |
| Organization Name | FIESTA PEDIATRIC THERAPY |
| Practice Address |
930 W Southern Ave Suite 10 Mesa AZ 85210-4938 |
| Mailing Address |
1641 E Osborn Rd Suite 1 Phoenix AZ 85016-7146 |
| Practice Telephone | 4808350857 |
| Practice Fax Number | 4808980138 |
| Mailing Telephone | 6022654124 |
| Mailing Fax Number | 6022488843 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARY ANN SHEELY (OWNER) |
| Authorized Official Telephone | 6022654124 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| X | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| X | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255711131 | Fiesta Pediatric Therapy | Early Intervention Provider Agency | 2302 N 15th Ave, Phoenix, AZ 85007-1201 | 2015-06-04 |
| Street Address |
930 W SOUTHERN AVE SUITE 10 |
| City | MESA |
| State | AZ |
| Zip Code | 85210-4938 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760798276 | Intissar Ann Greene | Speech-Language Pathologist | 930 W Southern Ave, Mesa, AZ 85210-4938 | 2010-08-20 |
| 1134317332 | Nina L Fuller | Speech-Language Pathologist | 930 W Southern Ave, Mesa, AZ 85210-4938 | 2007-10-12 |
| 1003946005 | Mary Ann Sheely | Occupational Therapist | 930 W Southern Ave, Ste 10, Mesa, AZ 85210-4938 | 2007-03-07 |
| 1699805606 | Amy Kneller | Occupational Therapist | 930 W Southern Ave, Ste 10, Mesa, AZ 85210-4938 | 2007-03-07 |
| 1801933122 | April Ariola | Speech-Language Pathologist | 930 W Southern Ave, Ste 101, Mesa, AZ 85210-4938 | 2007-01-30 |
| 1104963412 | Chad Romanoff | Occupational Therapist | 930 W Southern Ave, Ste 101, Mesa, AZ 85210-4938 | 2007-01-30 |
| 1750447652 | Erin Mcelwain | Speech-Language Pathologist | 930 W Southern Ave, Ste #10, Mesa, AZ 85210-4938 | 2006-12-28 |
| 1396800132 | Megan Aubry | Occupational Therapist | 930 W Southern Ave, Ste #10, Mesa, AZ 85210-4938 | 2006-12-22 |
| 1124181912 | Tracy Haakenson | Occupational Therapist | 930 W Southern Ave, Ste #10, Mesa, AZ 85210-4938 | 2006-12-19 |
| 1740343508 | Michele Carroll | Speech-Language Pathologist | 930 W Southern Ave, Ste #10, Mesa, AZ 85210-4938 | 2006-12-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497382501 | Mesa Center for Family Medicine | Internal Medicine | 2034 S Alma School Road, Suite #101, Mesa, AZ 85210 | 2020-03-26 |
| 1780177121 | Jessica Cannata | Speech-Language Pathologist | 2150 S Country Club Rd, Suite 20, Mesa, AZ 85210 | 2018-06-11 |
| 1831680305 | Alexandra Katherine Ebong | Nurse Practitioner | 1950 S. Country Club Drive, Ste 102, Mesa, AZ 85210 | 2018-05-21 |
| 1548762719 | Russell D. Meldrum, M.d. Pllc | Orthopaedic Surgery | 855 W. Southern Ave., #1114, Mesa, AZ 85210 | 2018-03-05 |
| 1023510435 | Denise M Bruno-krupp | Counselor | 1830 S. Alma School Rd. Suite 101, Mesa, AZ 85210 | 2018-03-01 |
| 1609374529 | Gene R Lullo | Social Worker | 1830 S Alma School Rd Suite 101, Mesa, AZ 85210 | 2018-01-25 |
| 1295264000 | Ashley P Smith | Naturopath | 601 S Alma School Rd, Apt 101, Mesa, AZ 85210 | 2017-06-06 |
| 1386184059 | Brittany Johnson | Counselor | 1745 S Alma School Rd Ste 230, Mesa, AZ 85210 | 2017-03-01 |
| 1487190880 | Mesa Valley Modern Dentistry, LLP | Dentist | 1712 S, Country Club Drive, Ste 104, Mesa, AZ 85210 | 2017-01-10 |
| 1821544529 | Sandra Coren | Licensed Practical Nurse | 32 S Mcdonald, Tlc, Mesa, AZ 85210 | 2016-09-01 |
| Find all providers in zip 85210 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245495829 | Kathleen Milner | Physical Therapist | 4554 E Inverness Ave Ste C-1, Mesa, AZ 85206-4639 | 2008-07-23 |
| 1245436468 | Mandy Marie Gandhi | Physical Therapist | 4554 E Inverness Ave Ste C1, Mesa, AZ 85206-4639 | 2007-06-25 |
| 1497968820 | Kristin Hix | Physical Therapist | 952 E. Baseline Rd., Suite A106, Mesa, AZ 85204 | 2007-05-08 |
| 1568583060 | Jennifer Lynne Weil | Physical Therapist | 11229 E Renfield Ave, Mesa, AZ 85212-4158 | 2007-04-02 |
| 1508929316 | Jessica Basha | Physical Therapist | 3403 E Main St # 208, Mesa, AZ 85213-8683 | 2006-12-19 |
| 1124194675 | Linda S Beckman | Physical Therapist | 1522 E Granada Cir, Mesa, AZ 85203-4420 | 2006-11-27 |
| 1467800128 | Stephanie Van De Water | Physical Therapist | 844 N Ellsworth Rd, Mesa, AZ 85207-5114 | 2016-06-02 |
| 1942660618 | S.e.e.k. Arizona, LLC | Physical Therapist | 1830 S Alma School Rd, Suite 130, Mesa, AZ 85210 | 2016-02-24 |
| 1326445156 | Emmah Njoki | Physical Therapist | 4542 E Inverness Ave, Mesa, AZ 85206-4619 | 2014-11-21 |
| 1043659659 | Amber Brennan | Physical Therapist | 844 N Ellsworth Rd, Mesa, AZ 85207-5114 | 2013-06-17 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.