NPIMap

Organization Active NPI

Spooner Rehab, PC

  • Physical Therapist
  • Peoria, AZ
National Provider Identifier
1225472533
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPOONER REHAB, PC
Practice address
13352 N 83Rd Ave
Suite a-101
Peoria, AZ 85381-4158
Phone
(623) 979-8900
Fax
(623) 979-1809
NPI assigned
Apr 18, 2013
Last updated
Jun 18, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
SPOONER REHAB, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Mr. Sylvia Mendoza
Title
Credentialing Coordinator
Phone
(480) 551-4961

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

13352 N 83Rd Ave
Suite a-101
Peoria, AZ 85381-4158

Mailing address

9097 E Desert Cove Ave
Suite 110
Scottsdale, AZ 85260-6710
Phone (480) 551-4961

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303001024 AZ Part B Supplier - Clinic/Group Practice 6608763610 Receives reassigned benefits from 3 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Peoria, AZ; Phoenix, AZ; Goodyear, AZ; Avondale, AZ

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory
Tax ID family
Spooner Rehab PC3 organizations share this tax ID, including this one
Part of
Spooner Rehab PC

Other organizations with this tax ID 2

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

Locations

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

Practitioners & affiliated clinicians

Practitioners 21

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 21

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1225472533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 E DESERT COVE AVE",
            "address_2": "SUITE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606710",
            "telephone_number": "480-551-4961",
            "fax_number": "480-860-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13352 N 83RD AVE",
            "address_2": "SUITE A-101",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814158",
            "telephone_number": "623-979-8900",
            "fax_number": "623-979-1809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPOONER REHAB, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPOONER REHAB, PC",
        "enumeration_date": "2013-04-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "480-551-4961",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.