NPIMap

Organization Active NPI

Spooner Physical Therapy & Hand Rehab, PC

Doing business as Spooner Ahwatukee

  • Physical Therapy Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1205057320
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
Doing business as
Spooner Ahwatukee
Practice address
16611 S 40TH St
Suite 130
Phoenix, AZ 85048-0562
Phone
(480) 706-1199
Fax
(480) 706-3999
NPI assigned
May 2, 2007
Last updated
Feb 19, 2025By the provider in NPPES
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

16611 S 40TH St
Suite 130
Phoenix, AZ 85048-0562

Mailing address

9097 E Desert Cove Ave Ste 110
Scottsdale, AZ 85260-6276
Phone (480) 706-1199

Other identifiers 1

IdentifierTypeStateIssuer
324787MedicaidAZ

Other names 1

  • SPOONER AHWATUKEE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000925 AZ Part B Supplier - Clinic/Group Practice 2769379759 Receives reassigned benefits from 14 practitioners
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory
Part of
Spooner Physical Therapy

Locations

1626 N Litchfield Rd
Ste 310
Goodyear, AZ 85395
Phone (623) 680-0036

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

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": "1205057320",
    "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": "480-706-1199",
            "fax_number": "480-706-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16611 S 40TH ST",
            "address_2": "SUITE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480562",
            "telephone_number": "480-706-1199",
            "fax_number": "480-706-3999"
        }
    ],
    "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": "324787",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPOONER AHWATUKEE",
            "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.