OrganizationActive
Mountainside Fitness Acquisitions, LLC
NPI 1639769649 · Sports Medicine (Physical Medicine & Rehabilitation) Physician · Glendale, AZ
Provider details
- NPI number
- 1639769649
- Entity type
- Organization
- Primary specialty
- Sports Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Eileen Ahern, Credentialist(800) 954-1800
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2020 N. 75th Avenue
Glendale, AZ 85308
Phone: (480) 625-0228
Approximate (ZIP-level) locationGet directions
Mailing address
7135 E Camelback Rd
Scottsdale, AZ 85251-1262
Registry dates
- Enumerated
- 2021-01-23
- Last updated
- 2021-01-23
- Certified
- 2021-01-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.