360 Physical Therapy LLC
Organization Active NPI Physical Therapist · Phoenix, AZ
NPI 1447604459 · NPPES record last updated Apr 15, 2016
Key facts
- NPI
- 1447604459
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- 360 PHYSICAL THERAPY LLC
- Practice address
- 4022 E Greenway Rd
Ste 1
Phoenix, AZ 85032-4797 - Phone
- (480) 821-1997
- Fax
- (480) 821-1887
- NPI assigned
- Apr 15, 2016
- Organization subpart
- No
Authorized official
- Name
- Cheryl Brunin
- Title
- Revenue Process Manager
- Phone
- (480) 821-1997
Other NPIs on the same Medicare enrollment 16
Corporate family (same tax ID) 14
Practitioners 4
-
Austin Carr, DPT
-
Melissa Kovar, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
National Provider Directory
- Tax ID family
- 360 Physical Therapy LLC
Locations
21083 N John Wayne Pkwy
Ste C104
Maricopa, AZ 85139
Phone (520) 233-7555
4022 E Greenway Rd
Ste 1
Phoenix, AZ 85032
Phone (480) 719-1644
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
4022 E Greenway Rd
Ste 1
Phoenix, AZ 85032-4797
Mailing address
4022 E Greenway Rd
Ste 1
Phoenix, AZ 85032-4797
Phone (480) 821-1997
Other providers in Phoenix, AZ
- 2Ffa Trans LLC
- 2MD Hospice Care LLC
- 2ND Home Skilled Care Services Arizona LLC
- 3 C Equine Service, PLLC
- 3 Peaks Medical Group, P.C.
- 360 Physical Therapy LLC
- 365 Recovery Clinic
- 3901 West PLLC
- 3Dcamouflageaz PLC
- 3Gpkids LLC
All providers in Phoenix, AZ · Physical Therapist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.