Individual provider Active NPI

Stephanie Phelps, DPT

  • Physical Therapist
  • Mesa, AZ
National Provider Identifier
1417386558
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10004 Issued in AZ
Practice address
5735 E McKellips Rd Ste 106
Mesa, AZ 85215-2875
Phone
(480) 269-7953
Fax
(480) 769-7269
NPI assigned
Nov 8, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 10004 AZ Primary

Addresses

Primary practice location

5735 E McKellips Rd Ste 106
Mesa, AZ 85215-2875

Mailing address

3461 E Amber LN
Gilbert, AZ 85296-1838
Phone (480) 213-5098

Other practice location 1

3104 E Indian School Rd Ste 120
Phoenix, AZ 85016-6873
Phone (480) 269-7953

Other practice location 2

3461 E Amber Ln
Gilbert, AZ 85296-1838
Phone (480) 213-5098

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251009004571 AZ Practitioner - Physical Therapist in Private Practice 7214434646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mind to Body Healing LLCGroup PAC ID 2769990266, 5 clinicians

Practice addresses (Care Compare)

3104 E Indian School Rd
Suite 120
Phoenix, AZ 85016-6873
Phone (480) 269-7953

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10004AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mind to Body Healing, LLC Physical Therapist CurrentSince Sep 25, 2025 Accepting new patients

Locations

5735 E McKellips Rd
Ste 106
Mesa, AZ 85215
Phone (480) 269-7953

3104 E Indian School Rd
Ste 120
Phoenix, AZ 85016
Phone (480) 269-7953

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1417386558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3461 E AMBER LN",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852961838",
            "telephone_number": "480-213-5098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 E MCKELLIPS RD STE 106",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852152875",
            "telephone_number": "480-269-7953",
            "fax_number": "480-769-7269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3104 E Indian School Rd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850166873",
            "country_code": "US",
            "telephone_number": "480-269-7953",
            "fax_number": "480-769-7269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3461 E Amber Ln",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852961838",
            "country_code": "US",
            "telephone_number": "480-213-5098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHELPS",
        "first_name": "STEPHANIE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-08",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "10004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.