MR. JORDAN BROOK MOCKTA ACSM-EP NPI 1548901176

NPI Information

NPI: 1548901176
Provider Name: MR. JORDAN BROOK MOCKTA, ACSM-EP
Classification: Clinical Exercise Physiologist - 224Y00000X
Entity Type: Individual
Address:
1500 E CEDAR AVE STE 52
FLAGSTAFF, AZ
ZIP 86004
Phone: (928) 773-1245
Get Directions

MR. Jordan Brook Mockta, ACSM-EP is a clinical exercise physiologist in Flagstaff, AZ. The provider is a Clinical Exercise Physiologist is a health care professional who is trained to work with patients with chronic disease where exercise training has been shown to be of therapeutic benefit, including but not limited to cardiovascular and pulmonary disease, and metabolic disorders. MR. Jordan Brook Mockta, ACSM-EP NPI is 1548901176. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1500 E CEDAR AVE STE 52
FLAGSTAFF, AZ
ZIP 86004-643
Phone: (928) 773-1245
Fax: (928) 773-9429

The enumeration date for this NPI number is 4/6/2022 and was last updated on 4/11/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	224Y00000X	Clinical Exercise Physiologist		1059346	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D04316506	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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