NPIMap

Organization Active NPI

360 Physical Therapy LLC

  • Specialist
  • Sun Lakes, AZ
National Provider Identifier
1164555074
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
360 PHYSICAL THERAPY LLC
Practice address
25229 S Sun Lakes Blvd 119
Sun Lakes, AZ 85248-5225
Phone
(480) 883-6734
Fax
(480) 895-8143
NPI assigned
Mar 13, 2007
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Tresha Baldwin, PT
Title
Owner, PT
Phone
(480) 821-1997

Other NPIs on the same Medicare enrollment 16

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

View all 16

Practitioners 9

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

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224000822 AZ Part B Supplier - Clinic/Group Practice 1355237645 Receives reassigned benefits from 144 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Queen Creek, AZ; Scottsdale, AZ; Sun Lakes, AZ; Surprise, AZ; Tempe, AZ; Goodyear, AZ; Mesa, AZ…

National Provider Directory

National Provider Directory
Tax ID family
360 Physical Therapy LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

25229 S Sun Lakes Blvd
Ste 119
Sun Lakes, AZ 85248
Phone (480) 883-6734

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

NPPES NPI Registry

Primary practice location

25229 S Sun Lakes Blvd 119
Sun Lakes, AZ 85248-5225

Mailing address

25229 S Sun Lakes Blvd
119
Sun Lakes, AZ 85248-7402
Phone (480) 883-6734

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 4, 2011.

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1164555074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25229 S SUN LAKES BLVD",
            "address_2": "119",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852487402",
            "telephone_number": "480-883-6734",
            "fax_number": "480-895-8143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25229 S SUN LAKES BLVD 119",
            "city": "SUN LAKES",
            "state": "AZ",
            "postal_code": "852485225",
            "telephone_number": "480-883-6734",
            "fax_number": "480-895-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "TRESHA",
        "authorized_official_title_or_position": "OWNER, PT",
        "authorized_official_telephone_number": "480-821-1997",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun Lakes, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.