Individual provider Active NPI

Carol A Weitkunat, P.T.

  • Physical Therapist
  • Prescott Valley, AZ
National Provider Identifier
1417907684
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3534 Issued in AZ
Practice address
2485 N Great Western Dr
Suite F2
Prescott Valley, AZ 86314-6528
Phone
(928) 775-2765
Fax
(928) 772-9170
NPI assigned
May 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 3534 AZ Primary

Addresses

Primary practice location

2485 N Great Western Dr
Suite F2
Prescott Valley, AZ 86314-6528

Mailing address

2485 N Great Western Dr
Suite F2
Prescott Valley, AZ 86314-6528
Phone (520) 249-6858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3534AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Care Physical Therapy PLLC PastSince Sep 27, 2004 Accepting new patients
Northern Arizona Orthosports Physical Therapy Inc Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417907684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 N GREAT WESTERN DR",
            "address_2": "SUITE F2",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863146528",
            "telephone_number": "520-249-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 N GREAT WESTERN DR",
            "address_2": "SUITE F2",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863146528",
            "telephone_number": "928-775-2765",
            "fax_number": "928-772-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITKUNAT",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "3534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.