Individual provider Active NPI

Michael Lee McKown, P.T.

  • Physical Therapist
  • Tempe, AZ
National Provider Identifier
1073656435
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5619 Issued in AZ
Practice address
1930 E Southern Ave
Tempe, AZ 85282-7518
Phone
(480) 456-0719
Fax
(480) 456-0719
NPI assigned
Feb 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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 5619 AZ Primary

Addresses

Primary practice location

1930 E Southern Ave
Tempe, AZ 85282-7518

Mailing address

1930 E Southern Ave
Tempe, AZ 85282-7518
Phone (480) 456-0719

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120112000546 AZ Practitioner - Physical Therapist in Private Practice 3971770082 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Solace Pediatric Healthcare Therapy Services Az, Inc. Physical Therapist CurrentSince Feb 20, 2018 Accepting new patients
Pioneer Pet, LLC PastSince Jan 26, 2020 Accepting new patients

Locations

1930 E Southern Ave
Tempe, AZ 85282
Phone (480) 456-0719

60 E Rio Salado Pkwy
Ste 900
Tempe, AZ 85281
Phone (480) 456-0719

Organizations & group practices 3

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1073656435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827518",
            "telephone_number": "480-456-0719",
            "fax_number": "480-456-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827518",
            "telephone_number": "480-456-0719",
            "fax_number": "480-456-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKOWN",
        "first_name": "MICHAEL",
        "middle_name": "LEE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; 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.