Active NPI
Philip Pace, PT, DPT
- Physical Therapist
- Tempe, AZ
National Provider Identifier
1619640778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-31866
- Practice address
- 1972 E Baseline Rd Ste 102
Tempe, AZ 85283-1532 - Phone
- (480) 730-0501
- NPI assigned
- Jul 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 | LPT-31866 | AZ | Primary |
Addresses
Primary practice location
1972 E Baseline Rd Ste 102
Tempe, AZ 85283-1532
Mailing address
3941 E Cody Ave
Gilbert, AZ 85234-3005
Phone (908) 894-0614
Other practice location 1
1255 W Baseline Rd Ste 140
Mesa, AZ 85202-5821
Phone (480) 820-7675
Other practice location 2
1255 W Baseline Rd
Mesa, AZ 85202-5820
Phone (480) 820-7675
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPT-31866 | Other | AZ | ARIZONA STATE BOARD OF PHYSICAL THERAPY |
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-31866 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627257600000",
"number": "1619640778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3941 E CODY AVE",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852343005",
"telephone_number": "908-894-0614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1972 E BASELINE RD STE 102",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852831532",
"telephone_number": "480-730-0501"
}
],
"practiceLocations": [
{
"address_1": "1255 W Baseline Rd Ste 140",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852025821",
"country_code": "US",
"telephone_number": "480-820-7675",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1255 W Baseline Rd",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852025820",
"country_code": "US",
"telephone_number": "480-820-7675",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PACE",
"first_name": "PHILIP",
"credential": "PT, DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-07-26",
"last_updated": "2021-07-26",
"certification_date": "2021-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-31866",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA STATE BOARD OF PHYSICAL THERAPY",
"identifier": "LPT-31866",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.