Individual provider Active NPI

Michelle Lynn Stillings, PT, DPT

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1104634781
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033992 Issued in AZ
Practice address
4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418
Phone
(480) 503-2373
NPI assigned
Dec 27, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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 033992 AZ Primary

Addresses

Primary practice location

4210 E Baseline Rd Ste 106
Mesa, AZ 85206-4418

Mailing address

7541 E Lompoc Cir
Mesa, AZ 85209-6231

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114003316 AZ Practitioner - Physical Therapist in Private Practice 4880122159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360 Physical Therapy LLCGroup PAC ID 1355237645, 87 clinicians

Practice addresses (Care Compare)

4210 E Baseline Rd
Suite 106
Mesa, AZ 85206-4418
Phone (480) 503-2373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033992AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
360 Physical Therapy LLC Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
360 Physical Therapy, LLC Current Accepting new patients
360 Physical Therapy LLC CurrentSince Jan 13, 2025 Accepting new patients
360 Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224
Phone 4808211997116

1472 E Williams Field Rd
Ste 1
Gilbert, AZ 85295

1472 E Williams Field Rd
Ste 100
Gilbert, AZ 85295

21083 N John Wayne Pkwy
Ste C104
Maricopa, AZ 85139
Phone (520) 233-7555

4210 E Baseline Rd
Ste 106
Mesa, AZ 85206
Phone (480) 503-2373

8322 E McDowell Rd
Ste 102
Scottsdale, AZ 85257
Phone (480) 941-4169

2600 Dallas Pkwy
Ste 290
Frisco, TX 75034
Phone (945) 260-0010

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": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1104634781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7541 E LOMPOC CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852096231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 E BASELINE RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064418",
            "telephone_number": "480-503-2373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLINGS",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "033992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.