Active NPI
Spooner Rehab, PC
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1093159378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- SPOONER REHAB, PC
- Practice address
- 2122 E Highland Ave
Suite 200
Phoenix, AZ 85016-4739 - Phone
- (602) 778-0900
- Fax
- (602) 778-6606
- NPI assigned
- Apr 17, 2013
- Organization subpart
- Yes
- Parent organization
- SPOONER REHAB,PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Timothy A Spooner, PT
- Title
- President
- Phone
- (480) 860-4298
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
2122 E Highland Ave
Suite 200
Phoenix, AZ 85016-4739
Mailing address
9097 E Desert Cove Ave
Suite 110
Scottsdale, AZ 85260-6710
Phone (480) 860-4298
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040303001024 | AZ | Part B Supplier - Clinic/Group Practice | 6608763610 |
Receives reassigned benefits from 3 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Peoria, AZ; Phoenix, AZ; Goodyear, AZ; Avondale, AZ |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Physical Therapy Clinic/Center
- Goodyear, AZ
- NPI 1437370525
O20040303001024
National Provider Directory
National Provider Directory- Tax ID family
- Spooner Rehab PC
- Part of
- Spooner Rehab PC
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Physical Therapist
- Peoria, AZ
- NPI 1225472533
-
- Physical Therapist
- Avondale, AZ
- NPI 1265876585
Locations
2122 E Highland Ave
Ste 200
Phoenix, AZ 85016
Phone (602) 778-0900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366156800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1372204800000",
"number": "1093159378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9097 E DESERT COVE AVE",
"address_2": "SUITE 110",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852606710",
"telephone_number": "480-860-4298",
"fax_number": "480-860-0356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2122 E HIGHLAND AVE",
"address_2": "SUITE 200",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850164739",
"telephone_number": "602-778-0900",
"fax_number": "602-778-6606"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SPOONER REHAB, PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SPOONER REHAB,PC",
"enumeration_date": "2013-04-17",
"last_updated": "2013-06-26",
"status": "A",
"authorized_official_last_name": "SPOONER",
"authorized_official_first_name": "TIMOTHY",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "480-860-4298",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
- Spooner Physical Therapy & Hand Rehab, PC
- Spooner Physical Therapy & Hand Rehab, PC
- Spooner Physical Therapy & Hand Rehab, PC
- Spooner Physical Therapy & Hand Rehab, PC
- Spooner Physical Therapy & Hand Rehab, PC
- Christopher Roy Spooner, NMD
- Shad Arthur Spooner
- Sports & Fam Care Clinic Inc
- Sports Conditioning Clinic
- Christine E Sports, RD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; 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.