NPIMap

Organization Active NPI

Spooner Chandler, PC

  • Physical Therapist
  • Chandler, AZ
National Provider Identifier
1043225816
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0962 Issued in AZ
Legal business name
SPOONER CHANDLER, PC
Practice address
1257 W Warner Rd
Suite a-2
Chandler, AZ 85224-2713
Phone
(480) 821-2286
Fax
(480) 899-9789
NPI assigned
Jul 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy Spooner, PT
Title
President
Phone
(480) 551-4958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 0962 AZ Primary

Addresses

Primary practice location

1257 W Warner Rd
Suite a-2
Chandler, AZ 85224-2713

Mailing address

1257 W Warner Rd
Suite a-2
Chandler, AZ 85224-2713
Phone (480) 821-2286

Other practice location 1

6824 E Brown Rd # 102
Mesa, AZ 85207-3705
Phone (480) 924-5514

Other identifiers 1

IdentifierTypeStateIssuer
913171MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040716001110 AZ Part B Supplier - Clinic/Group Practice 7618956244 Receives reassigned benefits from 12 practitioners
Practice locations: Mesa, AZ; Chandler, AZ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1043225816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 W WARNER RD",
            "address_2": "SUITE A-2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242713",
            "telephone_number": "480-821-2286",
            "fax_number": "480-899-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 W WARNER RD",
            "address_2": "SUITE A-2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852242713",
            "telephone_number": "480-821-2286",
            "fax_number": "480-899-9789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6824 E Brown Rd # 102",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852073705",
            "country_code": "US",
            "telephone_number": "480-924-5514",
            "fax_number": "480-924-5518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPOONER CHANDLER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "SPOONER",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-551-4958",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "0962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "913171",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.