NPIMap

Organization Active NPI

Orthopedic Therapy and Wellness, PLLC

Doing business as Orthopedic Sports Therapy

  • Orthopedic Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1710683248
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
ORTHOPEDIC THERAPY AND WELLNESS, PLLC
Doing business as
Orthopedic Sports Therapy
Practice address
4302 E Ray Rd Ste 105
Phoenix, AZ 85044-4706
Phone
(480) 597-4241
Fax
(480) 718-8160
NPI assigned
Feb 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Authorized official

Name
Shawna Tutell
Title
Office Manager
Phone
(480) 921-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

4302 E Ray Rd Ste 105
Phoenix, AZ 85044-4706

Mailing address

2525 S Rural Rd Ste 5S
Tempe, AZ 85282-2444
Phone (480) 921-9000

Other names 1

  • Orthopedic Sports Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130207000462 AZ Part B Supplier - Clinic/Group Practice 4880848415 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Tempe, AZ

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Orthopedic Therapy and Wellness3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2525 S Rural Rd
Ste 5S
Tempe, AZ 85282
Phone (480) 921-9000

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1710683248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 S RURAL RD STE 5S",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822444",
            "telephone_number": "480-921-9000",
            "fax_number": "480-718-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 E RAY RD STE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850444706",
            "telephone_number": "480-597-4241",
            "fax_number": "480-718-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC THERAPY AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A",
        "authorized_official_last_name": "TUTELL",
        "authorized_official_first_name": "SHAWNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "480-921-9000"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopedic Sports Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 3, 2024; 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.