Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Mrs. Jade Elise Fagan, PT

Individual provider Physical Therapist · NPI 1881989606

Mrs. Jade Elise Fagan, PT is a Physical Therapist in Phoenix, Arizona. Licensed in Arizona, Maryland, New Hampshire and Virginia. Registered with an NPI since 2011.

Licensed in
AZ, MD, NH, VA
In the registry since
2011
Specialties on file
4
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

11812 N 19th Ave
Phoenix, AZ 85029-3536
Phone: (602) 833-4177
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence LPT31072 (AZ)
Physical Therapist Taxonomy 225100000X · Licence CP053760T (MD)
Physical Therapist Taxonomy 225100000X · Licence CP051734T (NH)
Physical Therapist Taxonomy 225100000X · Licence CP052658T (VA)

Record details

NPI number1881989606
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT
Sole proprietorNo
NPI enumeratedJune 9, 2011
Last updated in NPPESSeptember 29, 2026
Certification dateSeptember 29, 2026

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