NPIMap

Organization Active NPI

360 Physical Therapy LLC

  • Specialist
  • Goodyear, AZ
National Provider Identifier
1649965427
Registry record updated Apr 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
360 PHYSICAL THERAPY LLC
Practice address
1382 S Cotton LN
Goodyear, AZ 85338-4657
Phone
(520) 438-7091
NPI assigned
Apr 7, 2023
Last updated
Apr 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2023

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

Authorized official

Name
Robert PaceNPI 1164643466
Title
Coo
Phone
(213) 804-1712

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1382 S Cotton LN
Goodyear, AZ 85338-4657

Mailing address

2035 Corte del Nogal Ste 200
Carlsbad, CA 92011-1445
Phone (760) 931-8310

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224000822 AZ Part B Supplier - Clinic/Group Practice 1355237645 Receives reassigned benefits from 144 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Queen Creek, AZ; Scottsdale, AZ; Sun Lakes, AZ; Surprise, AZ; Tempe, AZ; Goodyear, AZ; Mesa, AZ…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
360 Physical Therapy LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

3700 N 24th St
Ste 230
Phoenix, AZ 85016
Phone (602) 903-2343

8322 E McDowell Rd
Ste 102
Scottsdale, AZ 85257
Phone (480) 941-4169

8670 E Shea Blvd
Scottsdale, AZ 85260
Phone (913) 522-9964

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1649965427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2035 CORTE DEL NOGAL STE 200",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920111445",
            "telephone_number": "760-931-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1382 S COTTON LN",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853384657",
            "telephone_number": "520-438-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "213-804-1712"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.