NPIMap

Organization Active NPI

Spooner Physical Therapy & Hand Rehab, PC

  • Physical Therapy Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1104048248
Registry record updated Feb 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SPOONER PHYSICAL THERAPY & HAND REHAB, PC
Practice address
5040 N 15TH Ave Ste 401
Phoenix, AZ 85015-3332
Phone
(602) 285-0949
Fax
(602) 285-0052
NPI assigned
May 2, 2007
Organization subpart
Yes
Parent organization
SPOONER PHYSICAL THERAPY & HAND REHAB, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2025

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

Authorized official

Name
Timothy A Spooner, PT
Title
President
Phone
(480) 551-4958

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

5040 N 15TH Ave Ste 401
Phoenix, AZ 85015-3332

Mailing address

9097 E Desert Cove Ave Ste 110
Scottsdale, AZ 85260-6276
Phone (602) 285-0949

Other identifiers 1

IdentifierTypeStateIssuer
321509MedicaidAZ

Other names 1

  • SPOONER PHOENIX PHYSICAL THERAPY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040615001765 AZ Part B Supplier - Clinic/Group Practice 5496739617 Receives reassigned benefits from 13 practitioners
1 other NPI on this enrollment
Practice locations: Phoenix, AZ

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Spooner Physical Therap

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1104048248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 E DESERT COVE AVE STE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606276",
            "telephone_number": "602-285-0949",
            "fax_number": "602-285-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 N 15TH AVE STE 401",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153332",
            "telephone_number": "602-285-0949",
            "fax_number": "602-285-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOONER PHYSICAL THERAPY & HAND REHAB, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPOONER PHYSICAL THERAPY & HAND REHAB, PC",
        "enumeration_date": "2007-05-02",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "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": "480-551-4958",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "321509",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPOONER PHOENIX PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 19, 2025; 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.