White Tanks Physical Therapy & Ortho Rehab

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6122 Issued in AZ

Legal business name

WHITE TANKS PHYSICAL THERAPY & ORTHO REHAB

Practice address

White Tanks Physical Therapy and Ortho Rehab LLC
250 N Litchfield Rd Ste 155
Goodyear, AZ 85338

Phone

(623) 882-9787

Fax

(623) 882-9791

NPI assigned

Jul 29, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Sarah G Lujan

Title

Billing Representative

Phone

(623) 882-9787

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

White Tanks Physical Therapy and Orthope2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• White Tanks Physical Therapy and Orthopedic Rehabilitation LLC

  • Specialist
  • Goodyear, AZ
  • NPI 1194808600
  NPD tax ID

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cory David Ferguson, D.P.T.

  • Physical Therapist
  • Goodyear, AZ
  • NPI 1851586804
  NPD (past)
• Pablo Ruiz Jr., P.T.

  • Physical Therapist
  • Goodyear, AZ
  • NPI 1326043175
  NPD (past)

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

{
    "created_epoch": "1122595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386644599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2882 W GAIL DR",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852243963",
            "telephone_number": "480-704-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WHITE TANKS PHYSICAL THERAPY AND ORTHO REHAB LLC",
            "address_2": "250 N LITCHFIELD RD STE 155",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "85338",
            "telephone_number": "623-882-9787",
            "fax_number": "623-882-9791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE TANKS PHYSICAL THERAPY & ORTHO REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUJAN",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "BILLING REPRESENTATIVE",
        "authorized_official_telephone_number": "623-882-9787",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "916190",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley M Wheeler, APRN
• Ashley Renee Wheeler, PTA
• Kallen Wheeler, DMD
• Mark Delwyn Wheeler, D.M.D
• Devin Talmage Whipple, OD
• White Tanks Physical Therapy and Orthopedic Rehabilitation LLC
• Casey J White, DMD
• Crystal N White, MHCA
• Jazz Taylor White, MOTR/L
• Samantha White

• 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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.