Individual provider Active NPI

Kevin J Truitt, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1508175019
Registry record updated Oct 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9008 Issued in AZ
Practice address
20950 N Tatum Blvd
Suite100
Phoenix, AZ 85050-4200
Phone
(480) 502-5510
Fax
(480) 538-4862
NPI assigned
Sep 30, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2010

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 9008 AZ Primary

Addresses

Primary practice location

20950 N Tatum Blvd
Suite100
Phoenix, AZ 85050-4200

Mailing address

9097 E Desert Cove Ave
Suite 110
Scottsdale, AZ 85260-6710
Phone (480) 860-4298

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110314000879 AZ Practitioner - Physical Therapist in Private Practice 6406038371 Reassigns benefits to 1 organization

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
Foothills Sports Medicine and Rehabilitation LLCGroup PAC ID 2668457979, 172 clinicians

Practice addresses (Care Compare)

15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691
Phone (480) 940-8299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9008AZMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

19420 N 59th Ave
Ste H830
Glendale, AZ 85308
Phone (623) 302-9020

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

7707 W Deer Valley Rd
Ste 100
Peoria, AZ 85382
Phone (623) 376-9100

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

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.

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286409600000",
    "number": "1508175019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 E DESERT COVE AVE",
            "address_2": "SUITE 110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606710",
            "telephone_number": "480-860-4298",
            "fax_number": "480-860-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20950 N TATUM BLVD",
            "address_2": "SUITE100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504200",
            "telephone_number": "480-502-5510",
            "fax_number": "480-538-4862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUITT",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2010; 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.

Verify at the official NPI Registry.