Organization Active NPI

Dash Physical Therapy LLC

  • Physical Therapist
  • Queen Creek, AZ
National Provider Identifier
1407345523
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12454PT Issued in AZ
Legal business name
DASH PHYSICAL THERAPY LLC
Practice address
18530 E San Tan Blvd Ste 109
Queen Creek, AZ 85142-2201
Phone
(480) 677-8202
Fax
(480) 677-8203
NPI assigned
May 3, 2018
Last updated
Jun 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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

Authorized official

Name
Michael Heywood, DPTNPI 1790239226
Title
Therapist
Phone
(480) 677-8202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 12454PT AZ Primary

Addresses

Primary practice location

18530 E San Tan Blvd Ste 109
Queen Creek, AZ 85142-2201

Mailing address

18530 E San Tan Blvd Ste 109
Queen Creek, AZ 85142-2201
Phone (480) 677-8202

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180830001693 AZ Part B Supplier - Clinic/Group Practice 7113277864 Receives reassigned benefits from 4 practitioners
Practice locations: Queen Creek, AZ

National Provider Directory

National Provider Directory

Locations

18530 E San Tan Blvd
Queen Creek, AZ 85142

18530 E San Tan Blvd
Ste 109
Queen Creek, AZ 85142
Phone (480) 677-8202

18540 E San Tan Blvd
Ste 101
Queen Creek, AZ 85142
Phone (480) 677-8202

Practitioners & affiliated clinicians

Practitioners 7

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": "1525305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654646400000",
    "number": "1407345523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18530 E SAN TAN BLVD STE 109",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851422201",
            "telephone_number": "480-677-8202",
            "fax_number": "480-677-8203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18530 E SAN TAN BLVD STE 109",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851422201",
            "telephone_number": "480-677-8202",
            "fax_number": "480-677-8203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DASH PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-03",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A",
        "authorized_official_last_name": "HEYWOOD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "480-677-8202",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "12454PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.