Individual provider Active NPI

Edward Allen Carter, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1336462225
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10733 Issued in AZ
Practice address
2222 E Highland Ave
Suite 200
Phoenix, AZ 85016-4872
Phone
(602) 595-6180
Fax
(602) 595-7659
NPI assigned
Mar 5, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10733 AZ Primary
Orthopedic Physical Therapist 2251X0800X
Sports Physical Therapist 2251S0007X
Orthopedic Physical Therapist 2251X0800X PT36162 CA

Addresses

Primary practice location

2222 E Highland Ave
Suite 200
Phoenix, AZ 85016-4872

Mailing address

4715 N 32ND St
Suite 108
Phoenix, AZ 85018-3300
Phone (480) 689-5520

Other identifiers 1

IdentifierTypeStateIssuer
PT36162OtherCALICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140528000234 AZ Practitioner - Physical Therapist in Private Practice 9638356215 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Sports Medicine and Rehabilitation LLCGroup PAC ID 2668457979, 172 clinicians

Practice addresses (Care Compare)

15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691
Phone (480) 940-8299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10733AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Mar 30, 2015 Accepting new patients
Foothills Sports Medicine and Rehabilitation Biltmore LLC Physical Therapist CurrentSince Mar 17, 2014 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist Current Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Mar 30, 2015 Accepting new patients
Foothills Sports Medicine & Rehabilitation - Sun City, LLC Physical Therapist Past Accepting new patients
Sansum Clinic Past Accepting new patients
Hayashida & Associates Physical Therapy, Inc. Physical Therapist PastSince Feb 1, 2016 Accepting new patients
CBS-Oms PLLC Past Accepting new patients

Locations

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

2222 E Highland Ave
Ste 200
Phoenix, AZ 85016
Phone (602) 595-6180

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1336462225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4715 N 32ND ST",
            "address_2": "SUITE 108",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850183300",
            "telephone_number": "480-689-5520",
            "fax_number": "480-706-7409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 E HIGHLAND AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164872",
            "telephone_number": "602-595-6180",
            "fax_number": "602-595-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "EDWARD",
        "middle_name": "ALLEN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-05",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10733",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "PT36162",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT36162",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.