Stephanie Van de Water, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

LPT012270 Issued in AZ

Practice address

1076 W Chandler Blvd Ste 103
Chandler, AZ 85224-5223

Phone

(480) 821-1997

NPI assigned

Jun 2, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Stephanie Nadeau Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• 360 Physical Therapy, LLC

  • Specialist
  • Scottsdale, AZ
  • NPI 1932430949
  Medicare reassignment NPD
• 360 Physical Therapy LLC

  dba 360 Physical Therapy

  • Physical Therapist
  • Gilbert, AZ
  • NPI 1619592995
  NPD
• 360 Physical Therapy LLC

  dba 360 Physical Therapy

  • Physical Therapist
  • Queen Creek, AZ
  • NPI 1689115164
  NPD
• JWG, Inc

  • Physical Therapist
  • Mesa, AZ
  • NPI 1467599035
  NPD (past)

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

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1467800128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245223",
            "telephone_number": "480-821-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245223",
            "telephone_number": "480-821-1997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "844 N Ellsworth Rd",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852075114",
            "country_code": "US",
            "telephone_number": "480-380-2810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN DE WATER",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "LPT012270",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AZ",
            "license": "12270PT",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "NADEAU",
            "prefix": "MS.",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Diane Marie Van Dam
• Lindsay K Van Dam, N.P.
• Evan Van Driel, N.D.
• Jennifer Van Gheem, PT, DPT
• Megan Marie Van Over, O.D.
• Stacie Van Zuidam, BCBA, LBA
• Michelle Van

• Orthopedic Physical Therapist in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Orthopedic Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.