NPIMap

Organization Active NPI

BHSM Rehabilitation, LLC

Doing business as Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Mesa, AZ
National Provider Identifier
1306361357
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BHSM REHABILITATION, LLC
Doing business as
Banner Physical Therapy
Practice address
10165 E Hampton Ave Ste 111
Mesa, AZ 85209-3327
Phone
(480) 354-5424
Fax
(480) 354-1324
NPI assigned
Aug 11, 2017
Last updated
Oct 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Authorized official

Name
John F Duggan
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary
Rehabilitation Clinic/Center 261QR0400X AZ

Addresses

Primary practice location

10165 E Hampton Ave Ste 111
Mesa, AZ 85209-3327

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • Banner Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180306002185 AZ Part B Supplier - Clinic/Group Practice 2062773138 Receives reassigned benefits from 345 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Queen Creek, AZ; Scottsdale, AZ; Tempe, AZ; Tucson, AZ; Mesa, AZ; Peoria, AZ; Buckeye, AZ…
O20180515001336 AZ Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2062773138 Practice locations: Mesa, AZ; Queen Creek, AZ; Gilbert, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306361357. Details of each certification follow.

  • CCN 036596 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 036596

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BANNER PHYSICAL THERAPY AND REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jul 7, 2009
Last certification
Oct 29, 2021
Ownership / control type
Proprietary
Most recent change of ownership
May 1, 2018
Facility address
10165 East Hampton Avenue, Suite 111
Mesa, AZ 85209

Other NPIs on the same Medicare enrollment 37

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

View all 37

National Provider Directory

National Provider Directory
Part of
Select Medical Corporation

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2940 E Banner Gateway Dr
Ste 425
Gilbert, AZ 85234
Phone (480) 543-2000

2222 E Highland Ave
Ste 310
Phoenix, AZ 85016
Phone (602) 512-8550

20851 E Rittenhouse Rd
Ste E301
Queen Creek, AZ 85142

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1306361357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10165 E HAMPTON AVE STE 111",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093327",
            "telephone_number": "480-354-5424",
            "fax_number": "480-354-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHSM REHABILITATION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2017-08-11",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.