Individual provider Active NPI

Alexis Sutherland, PT, DPT

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1073350690
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033666 Issued in AZ
Practice address
17100 N 67TH Ave
Glendale, AZ 85308-3605
Phone
(623) 979-2747
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 033666 AZ Primary

Addresses

Primary practice location

17100 N 67TH Ave
Glendale, AZ 85308-3605

Mailing address

17100 N 67TH Ave
Glendale, AZ 85308-3605

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827002703 AZ Practitioner - Physical Therapist in Private Practice 4486193059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Nevada School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aris Health CorportationGroup PAC ID 6800818055, 4 clinicians

Practice addresses (Care Compare)

17100 N 67TH Ave
BLDG 100
Glendale, AZ 85308-3612
Phone (623) 979-2747

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033666AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aris Health Corportation Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients

Locations

17100 N 67th Ave
Ste 100
Glendale, AZ 85308
Phone (623) 979-2747

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1073350690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17100 N 67TH AVE",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853083605",
            "telephone_number": "623-979-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTHERLAND",
        "first_name": "ALEXIS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "033666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.