Individual provider Active NPI

Jeff L Devries, PT

  • Physical Therapist
  • Goodyear, AZ
National Provider Identifier
1073574653
Registry record updated Nov 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6808 Issued in AZ
Practice address
3050 N Litchfield Rd
Suite 100
Goodyear, AZ 85395-7804
Phone
(623) 935-5505
Fax
(623) 935-5551
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2007

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 6808 AZ Primary

Addresses

Primary practice location

3050 N Litchfield Rd
Suite 100
Goodyear, AZ 85395-7804

Mailing address

PO Box 32490
Phoenix, AZ 85064-2490
Phone (602) 248-4470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4734ORMDGeneral Practice Dentistry
6808AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vibrantcare Outpatient Rehabilitation West Inc PastSince Feb 19, 2023 Accepting new patients
Olympic Physical Therapy, Inc Physical Therapist Past Accepting new patients
Canyon State Physical Therapy Physical Therapist Past Accepting new patients
Vibrantcare Outpatient Rehabilitation West Inc Past Accepting new patients

Organizations & group practices 4

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194566400000",
    "number": "1073574653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32490",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850642490",
            "telephone_number": "602-248-4470",
            "fax_number": "602-266-1641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 N LITCHFIELD RD",
            "address_2": "SUITE 100",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853957804",
            "telephone_number": "623-935-5505",
            "fax_number": "623-935-5551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVRIES",
        "first_name": "JEFF",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2007-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.