Individual provider Active NPI

Madison Jepperson

  • Physical Therapist
  • Litchfield Park, AZ
National Provider Identifier
1346056223
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033928 Issued in AZ
Practice address
5110 N Dysart Rd
Litchfield Park, AZ 85340-3058
Phone
(623) 547-4739
NPI assigned
Dec 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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 033928 AZ Primary

Addresses

Primary practice location

5110 N Dysart Rd
Litchfield Park, AZ 85340-3058

Mailing address

14324 W Lexington Ave
Goodyear, AZ 85395-8486

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241223000500 AZ Practitioner - Physical Therapist in Private Practice 5294262788 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033928AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Oct 11, 2024 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Oct 11, 2024 Accepting new patients
Arizona Luna Care Physical Therapy, LLC Physical Therapist CurrentSince Feb 6, 2026 Accepting new patients

Locations

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

5110 N Dysart Rd
Ste 148
Litchfield Pk, AZ 85340
Phone (623) 547-4739

14050 N 83rd Ave
Ste 290
Peoria, AZ 85381
Phone (623) 261-1362

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

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

Organizations & group practices 3

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": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1346056223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14324 W LEXINGTON AVE",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 N DYSART RD",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403058",
            "telephone_number": "623-547-4739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPPERSON",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "033928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield Park, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.