NPIMap

Organization Active NPI

Impact Physical Therapy 3 LLC

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1194517359
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
IMPACT PHYSICAL THERAPY 3 LLC
Practice address
4575 E Cactus Rd Ste 130
Phoenix, AZ 85032-7700
Phone
(623) 208-7575
Fax
(866) 281-9664
NPI assigned
May 21, 2025
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Eric Hefferon, DPTNPI 1295061430
Title
Owner
Phone
(623) 208-7575

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4575 E Cactus Rd Ste 130
Phoenix, AZ 85032-7700

Mailing address

4575 E Cactus Rd Ste 130
Phoenix, AZ 85032-7700
Phone (623) 208-7575

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250722001891 AZ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2668988171 Receives reassigned benefits from 9 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

4575 E Cactus Rd
Ste 130
Phoenix, AZ 85032
Phone (602) 482-0994

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1747785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1194517359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4575 E CACTUS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327700",
            "telephone_number": "623-208-7575",
            "fax_number": "866-281-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 E CACTUS RD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327700",
            "telephone_number": "623-208-7575",
            "fax_number": "866-281-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT PHYSICAL THERAPY 3 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-21",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "HEFFERON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-208-7575",
        "authorized_official_credential": "DPT"
    },
    "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 May 21, 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.