Individual provider Active NPI

Robert Thorson, PT, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1669087664
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-31301 Issued in AZ
Practice address
11411 N 19TH Ave
Phoenix, AZ 85029-3642
Phone
(602) 256-7500
NPI assigned
Sep 15, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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 LPT-31301 AZ Primary

Addresses

Primary practice location

11411 N 19TH Ave
Phoenix, AZ 85029-3642

Mailing address

2433 W Main St Apt 298
Mesa, AZ 85201-7836
Phone (630) 777-2667

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201001002678 AZ Practitioner - Physical Therapist in Private Practice 5193144657 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Spine and Sport Physical Therapy LLCGroup PAC ID 7214003276, 3 clinicians

Practice addresses (Care Compare)

3485 S Mercy Rd
Suite 101
Gilbert, AZ 85297-0429
Phone (480) 963-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Doug S Clouse MD PLC CurrentSince Sep 23, 2020 Accepting new patients
Doug S Clouse MD PLC CurrentSince Sep 23, 2020 Accepting new patients
Spectrum Spine and Sport Physical Therapy LLC Physical Therapist CurrentSince Dec 4, 2020 Accepting new patients

Locations

2450 S Gilbert Rd
Ste 109
Chandler, AZ 85286

3485 S Mercy Rd
Ste 101
Gilbert, AZ 85297
Phone (480) 507-2044

Organizations & group practices 3

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": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1669087664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2433 W MAIN ST APT 298",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852017836",
            "telephone_number": "630-777-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11411 N 19TH AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850293642",
            "telephone_number": "602-256-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSON",
        "first_name": "ROBERT",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31301",
            "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 Sep 15, 2020; 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.