Organization Active NPI

Spooner Rehab, PC

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1093159378
Registry record updated Jun 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
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,PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2013

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)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 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 IDStateProvider typePAC IDDetails
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.

National Provider Directory

National Provider Directory
Tax ID family
Spooner Rehab PC3 organizations share this tax ID, including this one
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.

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

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.

Verify at the official NPI Registry.