Active NPI
Denise M Eldred, PT
- Orthopedic Physical Therapist
- Prescott Valley, AZ
National Provider Identifier
1720031081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 007171
- Practice address
- 9100 N Full Moon Rd
Prescott Valley, AZ 86315-6880 - Phone
- (928) 830-0322
- NPI assigned
- May 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 007171 | AZ | Primary |
Addresses
Primary practice location
9100 N Full Moon Rd
Prescott Valley, AZ 86315-6880
Mailing address
9100 N Full Moon Rd
Prescott Valley, AZ 86315-6880
Phone (928) 830-0322
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060628000153 | AZ | Practitioner - Physical Therapist in Private Practice | 4789696204 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9000 E San Victor Dr
Scottsdale, AZ 85258-5051
Phone (623) 299-7784
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007171 | AZ | MD | Emergency Medicine Physician |
| 7171 | AZ | MD | Speech-Language Assistant |
Organizations & group practices 1
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": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717632000000",
"number": "1720031081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9100 N FULL MOON RD",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863156880",
"telephone_number": "928-830-0322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9100 N FULL MOON RD",
"city": "PRESCOTT VALLEY",
"state": "AZ",
"postal_code": "863156880",
"telephone_number": "928-830-0322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDRED",
"first_name": "DENISE",
"middle_name": "M",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2024-06-06",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "AZ",
"license": "007171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Prescott Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.