NPIMap

Organization Active NPI

Gavilan Peak Physical Therapy

  • Physical Therapist
  • Anthem, AZ
National Provider Identifier
1306049655
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5242 Issued in AZ
Legal business name
GAVILAN PEAK PHYSICAL THERAPY
Practice address
3624 W Anthem Way Ste C106
Anthem, AZ 85086-0454
Phone
(623) 551-5121
Fax
(623) 551-5314
NPI assigned
Jun 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Hans A Karlsson, PTNPI 1538227780
Title
Owner
Phone
(623) 551-5121

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 5242 AZ Primary

Addresses

Primary practice location

3624 W Anthem Way Ste C106
Anthem, AZ 85086-0454

Mailing address

2834 W Anthem Way C106
Anthem, AZ 85086
Phone (623) 551-5121

National Provider Directory

National Provider Directory

Locations

3701 W Anthem Way
Ste 110
Anthem, AZ 85086
Phone (623) 551-5315

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306049655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 W ANTHEM WAY C106",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "85086",
            "telephone_number": "623-551-5121",
            "fax_number": "623-551-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 W ANTHEM WAY STE C106",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "850860454",
            "telephone_number": "623-551-5121",
            "fax_number": "623-551-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAVILAN PEAK PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KARLSSON",
        "authorized_official_first_name": "HANS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-551-5121",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anthem, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.