Active NPI
Adebola Adekanmbi, PT
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1265521702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 3951
- Practice address
- 8433 N Black Canyon Hwy
Phoenix, AZ 85021-4873 - Phone
- (623) 939-3112
- Fax
- (623) 939-3106
- NPI assigned
- Oct 12, 2006
- Last updated
- Jun 4, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3951 | AZ | Primary |
| Geriatric Physical Therapist | 2251G0304X | 3951 | AZ | |
| Neurology Physical Therapist | 2251N0400X | 3951 | AZ | |
| Pediatric Physical Therapist | 2251P0200X | 3951 | AZ |
Addresses
Primary practice location
8433 N Black Canyon Hwy
Phoenix, AZ 85021-4873
Mailing address
PO Box 39717
Phoenix, AZ 85069-9717
Phone (623) 939-3112
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 495160 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3951 | AZ | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Genesis Rehabilitation Services | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748995200000",
"number": "1265521702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 39717",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850699717",
"telephone_number": "623-939-3112",
"fax_number": "623-939-3106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8433 N BLACK CANYON HWY",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850214873",
"telephone_number": "623-939-3112",
"fax_number": "623-939-3106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADEKANMBI",
"first_name": "ADEBOLA",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2025-06-04",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "3951",
"primary": true
},
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "AZ",
"license": "3951",
"primary": false
},
{
"code": "2251N0400X",
"taxonomy_group": "",
"desc": "Physical Therapist, Neurology",
"state": "AZ",
"license": "3951",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AZ",
"license": "3951",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "495160",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
- Thomas Edward Addison, PHARM.D.
- Addus Healthcare, Inc. (Addus HomeCare)
- Robert Addy
- Winifred A Adebiyi
- Modupe R Adedoja, NP
- Adel Shayegan DMD PC
- Adelante Healthcare, Inc (Adelante Healthcare-Phoenix)
- Adelante Healthcare, Inc
- Adelante Healthcare, Inc (Adelante Healthcare-Roosevelt)
- Adelante Healthcare, Inc (Adelante Healthcare West Phoenix Behavioral Health)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.