Organization Active NPI

Summit Physical Therapy Az LLC

  • Physical Therapist
  • Gilbert, AZ
National Provider Identifier
1376043521
Registry record updated Mar 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7447 Issued in AZ
Legal business name
SUMMIT PHYSICAL THERAPY AZ LLC
Practice address
891 E Warner Rd # a-100
Gilbert, AZ 85296-2965
Phone
(480) 271-9756
NPI assigned
Feb 14, 2018
Last updated
Mar 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2018

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

Authorized official

Name
Barb Davis
Title
Billing Manager
Phone
(602) 697-3488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 7447 AZ Primary

Addresses

Primary practice location

891 E Warner Rd # a-100
Gilbert, AZ 85296-2965

Mailing address

891 E Warner Rd # a-100
Gilbert, AZ 85296-2965
Phone (480) 271-9756

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180425000040 AZ Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6305109489 Receives reassigned benefits from 2 practitioners
Practice locations: Gilbert, AZ; Mesa, AZ

National Provider Directory

National Provider Directory

Locations

891 E Warner Rd
#A100
Gilbert, AZ 85296
Phone (480) 271-9756

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520726400000",
    "number": "1376043521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "891 E WARNER RD # A-100",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962965",
            "telephone_number": "480-271-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "891 E WARNER RD # A-100",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852962965",
            "telephone_number": "480-271-9756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PHYSICAL THERAPY AZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-14",
        "last_updated": "2018-03-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BARB",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "602-697-3488"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "7447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2018; 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.