Active NPI
Edward R Flamand, PT
- Physical Therapist
- Wickenburg, AZ
National Provider Identifier
1477829174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9487
- Practice address
- 1175 W Wickenburg Way Ste 3
Wickenburg, AZ 85390-2262 - Phone
- (928) 668-0108
- Fax
- (928) 668-0110
- NPI assigned
- Mar 27, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9487 | AZ | Primary |
Addresses
Primary practice location
1175 W Wickenburg Way Ste 3
Wickenburg, AZ 85390-2262
Mailing address
1175 W Wickenburg Way Ste 3
Wickenburg, AZ 85390-2262
Phone (928) 668-0108
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104774 | Medicaid | AZ | |
| P01623030 | Other | AZ | RAILROAD MEDICARE |
| Z1186507 | Other | AZ | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1175 W Wickenburg Way
Suite 3
Wickenburg, AZ 85390-2262
Phone (928) 668-0108
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9487 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Champion Physical Therapy LLC | Current | Accepting new patients | |
| Northwest Orthopedic & Sports Physical Therapy LLC | Past | Accepting new patients |
Locations
2000 W Wickenburg Way
Ste 200
Wickenburg, AZ 85390
Phone (928) 668-0108
1175 W Wickenburg Way
Ste 3
Wickenburg, AZ 85390
Phone (928) 668-0108
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.
-
- Physical Therapy Clinic/Center
- Wickenburg, AZ
- NPI 1487833893
-
- Orthopedic Physical Therapist
- Sun City West, AZ
- NPI 1073610440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659744000000",
"number": "1477829174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1175 W WICKENBURG WAY STE 3",
"city": "WICKENBURG",
"state": "AZ",
"postal_code": "853902262",
"telephone_number": "928-668-0108",
"fax_number": "928-668-0110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1175 W WICKENBURG WAY STE 3",
"city": "WICKENBURG",
"state": "AZ",
"postal_code": "853902262",
"telephone_number": "928-668-0108",
"fax_number": "928-668-0110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAMAND",
"first_name": "EDWARD",
"middle_name": "R",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-03-27",
"last_updated": "2022-08-06",
"certification_date": "2022-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "9487",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104774",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01623030",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "Z1186507",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wickenburg, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.