NPIMap

Organization Active NPI

BHSM Rehabilitation, LLC

Doing business as Banner Physical Therapy

  • Physical Therapy Clinic/Center
  • Glendale, AZ
National Provider Identifier
1528535689
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
BHSM REHABILITATION, LLC
Doing business as
Banner Physical Therapy
Practice address
5605 W Eugie Ave Ste 212&215
Glendale, AZ 85304-1272
Phone
(480) 210-6445
Fax
(480) 795-6160
NPI assigned
Oct 26, 2018
Last updated
Oct 10, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SELECT MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 10, 2025

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

Authorized official

Name
John F Duggan
Title
Vice President
Phone
(717) 972-1100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary
Rehabilitation Clinic/Center 261QR0400X NU

Addresses

Primary practice location

5605 W Eugie Ave Ste 212&215
Glendale, AZ 85304-1272

Mailing address

4714 Gettysburg Rd
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100

Other names 1

  • Banner Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181126000543 AZ Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2062773138 Practice locations: Glendale, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1528535689. Details of each certification follow.

  • CCN 036610 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 036610

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BANNER PHYSICAL THERAPY AND REHABILITATION
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Mar 18, 2019
Last certification
Jul 14, 2022
Ownership / control type
Proprietary
Facility address
5605 West Eugie Avenue, Suite 212
Glendale, AZ 85304

National Provider Directory

National Provider Directory
Tax ID family
BHSM Rehabilitation LLC46 organizations share this tax ID, including this one
Part of
Select Medical Corporation

Other organizations with this tax ID 45

Organizations that report the same tax identification number in the National Provider Directory.

View all 45

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

Locations

5605 W Eugie Ave
Ste 212215
Glendale, AZ 85304
Phone (480) 210-6445

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1540512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760054400000",
    "number": "1528535689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5605 W EUGIE AVE STE 212&215",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041272",
            "telephone_number": "480-210-6445",
            "fax_number": "480-795-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHSM REHABILITATION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SELECT MEDICAL",
        "enumeration_date": "2018-10-26",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A",
        "authorized_official_last_name": "DUGGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Banner Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.