NPIMap

Organization Active NPI

360 Physical Therapy LLC

  • Physical Therapist
  • Queen Creek, AZ
National Provider Identifier
1689115164
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
360 PHYSICAL THERAPY LLC
Practice address
21576 S Ellsworth Loop Rd
150
Queen Creek, AZ 85142
Phone
(480) 821-1997
Fax
(480) 782-5213
NPI assigned
Mar 16, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Authorized official

Name
Cheryl Brunin
Title
Revenue Process Manager
Phone
(480) 821-1997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

21576 S Ellsworth Loop Rd
150
Queen Creek, AZ 85142

Mailing address

21576 S Ellsworth Loop Rd
150
Queen Creek, AZ 85142
Phone (480) 821-1997

Other names 1

  • 360 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
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

3921 E Baseline Rd
Ste 105
Gilbert, AZ 85234
Phone (480) 503-2373

3921 E Baseline Rd
Ste 106
Gilbert, AZ 85234

1382 S Cotton Ln
Goodyear, AZ 85338
Phone (520) 438-7090

21576 S Ellsworth Loop Rd
Ste 108
Queen Creek, AZ 85142
Phone (602) 737-2275

21576 S Ellsworth Loop Rd
#150
Queen Creek, AZ 85142

12701 N Scottsdale Rd
#360
Scottsdale, AZ 85254

1805 N Scottsdale Rd
Ste 103
Tempe, AZ 85288

1805 N Scottsdale Rd
Ste 2
Tempe, AZ 85288
Phone (480) 941-4169

Practitioners & affiliated clinicians

Practitioners 153

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 153

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1689115164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21576 S ELLSWORTH LOOP RD",
            "address_2": "150",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85142",
            "telephone_number": "480-821-1997",
            "fax_number": "480-782-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21576 S ELLSWORTH LOOP RD",
            "address_2": "150",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "85142",
            "telephone_number": "480-821-1997",
            "fax_number": "480-782-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "BRUNIN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "REVENUE PROCESS MANAGER",
        "authorized_official_telephone_number": "480-821-1997"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "360 Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.