Individual provider Active NPI

Corinne Margaret Oliphant, DPT

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1306703558
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-034544 Issued in AZ
Practice address
5761 E Brown Rd Ste 19
Mesa, AZ 85205-4449
Phone
(480) 719-8080
Fax
(480) 981-8595
NPI assigned
Jan 8, 2026
Last updated
Jan 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X LPT-034544 AZ Primary

Addresses

Primary practice location

5761 E Brown Rd Ste 19
Mesa, AZ 85205-4449

Mailing address

1844 E Baseline Rd Ste C5
Tempe, AZ 85283-1506
Phone (480) 833-1005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260309003319 AZ Practitioner - Physical Therapist in Private Practice 8325521305 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Creighton University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Petersen Physical Therapy PCGroup PAC ID 5991794117, 14 clinicians

Practice addresses (Care Compare)

6840 E Brown Rd
Suite 104
Mesa, AZ 85207-3759
Phone (480) 779-4671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-034544AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Petersen Physical Therapy PC CurrentSince Dec 17, 2025 Accepting new patients

Locations

5761 E Brown Rd
Ste 19
Mesa, AZ 85205
Phone (480) 719-8080

6840 E Brown Rd
Ste 104
Mesa, AZ 85207
Phone (480) 719-8080

1844 E Baseline Rd
Ste C5
Tempe, AZ 85283
Phone (480) 833-1005

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": "1767830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767830400000",
    "number": "1306703558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 E BASELINE RD STE C5",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831506",
            "telephone_number": "480-833-1005",
            "fax_number": "480-833-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5761 E BROWN RD STE 19",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054449",
            "telephone_number": "480-719-8080",
            "fax_number": "480-981-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIPHANT",
        "first_name": "CORINNE",
        "middle_name": "MARGARET",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-08",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-034544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.