Active NPI
Nicholas Rhys Andershock, PT
- Physical Therapist
- Goodyear, AZ
National Provider Identifier
1497264287
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-30072
- Practice address
- 250 N Litchfield Rd Ste 155
Goodyear, AZ 85338-1367 - Phone
- (623) 882-9787
- NPI assigned
- Sep 25, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT026436 | PA | |
| Physical Therapist | 225100000X | LPT-30072 | AZ | Primary |
Addresses
Primary practice location
250 N Litchfield Rd Ste 155
Goodyear, AZ 85338-1367
Mailing address
8522 N 114TH Ave
Peoria, AZ 85345-3450
Phone (219) 707-6439
Other practice location 1
3700 N Windsong Dr
Prescott Valley, AZ 86314-1253
Phone (928) 759-8800
Other practice location 2
625 Walnut St
McKeesport, PA 15132-2806
Phone (412) 673-5005
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497264287 | Medicaid | PA |
Other names 1
- Dr. Nicholas Rhys Andershock
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPT-30072 | AZ | MD | Physical Therapist |
| PT026436 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1506297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1497264287",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8522 N 114TH AVE",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853453450",
"telephone_number": "219-707-6439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 N LITCHFIELD RD STE 155",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853381367",
"telephone_number": "623-882-9787"
}
],
"practiceLocations": [
{
"address_1": "3700 N Windsong Dr",
"address_purpose": "LOCATION",
"city": "Prescott Valley",
"state": "AZ",
"postal_code": "863141253",
"country_code": "US",
"telephone_number": "928-759-8800",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "625 Walnut St",
"address_purpose": "LOCATION",
"city": "McKeesport",
"state": "PA",
"postal_code": "151322806",
"country_code": "US",
"telephone_number": "412-673-5005",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDERSHOCK",
"first_name": "NICHOLAS",
"middle_name": "RHYS",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-25",
"last_updated": "2020-12-08",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT026436",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-30072",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1497264287",
"state": "PA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NICHOLAS",
"last_name": "ANDERSHOCK",
"middle_name": "RHYS",
"prefix": "DR.",
"credential": "PT, DPT, COMT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.