Everest Pediatric Therapy LLC
Clinic/Center, Rehabilitation in Mesa, AZ. Organization (NPI-2).
NPI number1629935481
StatusActive
Last updated in NPPESJan 5, 2026
Details
- NPI
- 1629935481
- Entity type
- Organization (NPI-2)
- Legal business name
- Everest Pediatric Therapy LLC
- Organization subpart
- No
- Enumeration date
- Jan 5, 2026
- Certification date
- Jan 5, 2026
- Last updated
- Jan 5, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0400X | Clinic/Center, Rehabilitation | – | – | Yes |
Practice location
4864 E Baseline Rd Ste 105Mesa, AZ 85206-4629
Phone 480-734-5595 · Fax 480-633-6086
Mailing address
4864 E Baseline Rd Ste 105Mesa, AZ 85206-4629
Phone 480-734-5595 · Fax 480-633-6086
Authorized official
Cynthia Ruddell
Ceo
4807345595
Is something wrong?
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