Individual provider Active NPI

William John Whitlock, DPT

  • Physical Therapist
  • Watertown, SD
National Provider Identifier
1689279119
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3500 12TH Ave NW
Watertown, SD 57201
Phone
(605) 881-4179
NPI assigned
Dec 2, 2020
Last updated
Mar 3, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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 NU Primary

Addresses

Primary practice location

3500 12TH Ave NW
Watertown, SD 57201

Mailing address

14287 N 87TH St Ste 220
Scottsdale, AZ 85260-3698
Phone (602) 559-9707

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210216002774 AZ Practitioner - Physical Therapist in Private Practice 6103231550 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4955 S Alma School Rd
Suite 16
Chandler, AZ 85248-5640
Phone (480) 682-5460

9097 E Desert Cove Ave
Suite 110
Scottsdale, AZ 85260-6276
Phone (480) 924-5514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince Feb 5, 2021 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Current Accepting new patients
Arizona Luna Care Physical Therapy, LLC Physical Therapist CurrentSince Jun 13, 2023 Accepting new patients
Spooner Physical Therapy & Hand Rehab PC Physical Therapist CurrentSince Feb 5, 2021 Accepting new patients

Locations

4955 S Alma School Rd
Ste 16
Chandler, AZ 85248
Phone (480) 682-5460

14050 N 83rd Ave
Ste 290
Peoria, AZ 85381
Phone (623) 261-1362

14287 N 87th St
Ste 220
Scottsdale, AZ 85260

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1689279119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14287 N 87TH ST STE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603698",
            "telephone_number": "602-559-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 12TH AVE NW",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "57201",
            "telephone_number": "605-881-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-02",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.