Individual provider Active NPI

Sean Michael McQueeney, MPT, ATC, CSCS

  • Sports Physical Therapist
  • Peoria, AZ
National Provider Identifier
1477518553
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
6629 Issued in AZ
Practice address
15707 N 83Rd Ave
Peoria, AZ 85382-3827
Phone
(623) 776-4854
Fax
(623) 776-4826
NPI assigned
Apr 20, 2006
Last updated
Jan 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 6629 AZ Primary
Athletic Trainer 2255A2300X 0550 AZ

Addresses

Primary practice location

15707 N 83Rd Ave
Peoria, AZ 85382-3827

Mailing address

11950 W Flores Dr
El Mirage, AZ 85335-4304
Phone (623) 466-8348

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
0550AZMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Orthopaedics and Spinal Surgery, PA PastSince Apr 18, 2016 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1477518553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11950 W FLORES DR",
            "city": "EL MIRAGE",
            "state": "AZ",
            "postal_code": "853354304",
            "telephone_number": "623-466-8348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15707 N 83RD AVE",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853823827",
            "telephone_number": "623-776-4854",
            "fax_number": "623-776-4826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUEENEY",
        "first_name": "SEAN",
        "middle_name": "MICHAEL",
        "credential": "MPT, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "AZ",
            "license": "6629",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "0550",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.