Brennan Bonnett

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

13575 W McDowell Rd
Goodyear, AZ 85395-2604

Phone

(623) 536-9911

NPI assigned

Jun 23, 2020

Last updated

Jun 23, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Phoenix Mountain Therapy LLC

  dba Phoenix Mountain Therapy

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1053122689
  Medicare reassignment NPD

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1356967509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 N 87TH LN",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853531338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13575 W MCDOWELL RD",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853952604",
            "telephone_number": "623-536-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONNETT",
        "first_name": "BRENNAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bodyworx Health Studio LLC
• Carolyn Marie Boehmer
• Anthony B. Bolden, PA-C
• Amanda Bonano
• Jamie Bone
• Ronald John Borgstrom II
• Shelby Botello, PHARMD
• Malik Bourghli, DDS
• Joel T Bowen II, DPM
• Mark Bower

• Physical Therapist in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.