Individual provider Active NPI

Caleb Lynch, PT, DPT, CERT DN

  • Physical Therapist
  • Green Valley, AZ
National Provider Identifier
1457984841
Registry record updated Jun 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30956 Issued in AZ
Practice address
1055 N la Canada Dr Ste 123
Green Valley, AZ 85614-3700
Phone
(520) 462-0439
NPI assigned
Feb 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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 30956 AZ Primary

Addresses

Primary practice location

1055 N la Canada Dr Ste 123
Green Valley, AZ 85614-3700

Mailing address

3017 S Patrick Cir
Tucson, AZ 85730-2911
Phone (678) 994-9572

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200324000924 AZ Practitioner - Physical Therapist in Private Practice 3577991637 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30956AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aw Broadway and Craycroft, LLC Physical Therapist CurrentSince Jan 2, 2024 Accepting new patients
Arenson Wasserbeck LLC Physical Therapist CurrentSince Jan 2, 2024 Accepting new patients
Arizona Luna Care Physical Therapy, LLC Physical Therapist CurrentSince Jun 27, 2023 Accepting new patients

Locations

4850 E Baseline Rd
Ste 114
Mesa, AZ 85206
Phone (480) 396-2781

14050 N 83rd Ave
Ste 290
Peoria, AZ 85381
Phone (623) 261-1362

5545 E Broadway Blvd
Ste 113
Tucson, AZ 85711
Phone (520) 372-2714

1360 W Irvington Rd
Ste 280
Tucson, AZ 85746
Phone (520) 372-2724

1370 N Silverbell Rd
Ste 160
Tucson, AZ 85745
Phone (520) 372-2724

Organizations & group practices 3

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": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1457984841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 S PATRICK CIR",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857302911",
            "telephone_number": "678-994-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N LA CANADA DR STE 123",
            "city": "GREEN VALLEY",
            "state": "AZ",
            "postal_code": "856143700",
            "telephone_number": "520-462-0439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "CALEB",
        "credential": "PT, DPT, CERT DN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-13",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "30956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; 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.