NPIMap

Organization Active NPI

360 Physical Therapy LLC

Doing business as 360 Physical Therapy

  • Physical Therapist
  • Surprise, AZ
National Provider Identifier
1386318699
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
360 PHYSICAL THERAPY LLC
Doing business as
360 Physical Therapy
Practice address
11340 W Bell Rd
Surprise, AZ 85378-9342
Phone
(623) 226-6644
Fax
(623) 522-4042
NPI assigned
Aug 2, 2021
Last updated
Dec 17, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
360 PHYSICAL THERAPY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Cheryl Hunnel Brunin
Title
VP of Revenue Management
Phone
(480) 821-1997

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X
Physical Therapist 225100000X Primary

Addresses

Primary practice location

11340 W Bell Rd
Surprise, AZ 85378-9342

Mailing address

1076 W Chandler Blvd Ste 103
Chandler, AZ 85224-5223
Phone (480) 821-1997

Other identifiers 1

IdentifierTypeStateIssuer
300502MedicaidAZ

Other names 1

  • 360 Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224000822 AZ Part B Supplier - Clinic/Group Practice 1355237645 Receives reassigned benefits from 144 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Queen Creek, AZ; Scottsdale, AZ; Sun Lakes, AZ; Surprise, AZ; Tempe, AZ; Goodyear, AZ; Mesa, AZ…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
360 Physical Therapy LLC15 organizations share this tax ID, including this one
Part of
360 Physical Therapy LLC

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Practitioners & affiliated clinicians

Practitioners 8

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": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1386318699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245223",
            "telephone_number": "480-821-1997",
            "fax_number": "480-821-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 W BELL RD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853789342",
            "telephone_number": "623-226-6644",
            "fax_number": "623-522-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 PHYSICAL THERAPY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "360 PHYSICAL THERAPY LLC",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "BRUNIN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "HUNNEL",
        "authorized_official_title_or_position": "VP OF REVENUE MANAGEMENT",
        "authorized_official_telephone_number": "480-821-1997"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300502",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "360 Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "360 Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Surprise, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.