Jeremy Wolters

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-32441 Issued in AZ

Practice address

5110 N Dysart Rd Ste 148
Litchfield Park, AZ 85340-3062

Phone

(623) 547-4739

Fax

(623) 536-2154

NPI assigned

Jul 6, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Foothills Sports Medicine & Rehabilitation Litchfield Park, LLC

  • Physical Therapist
  • Litchfield Park, AZ
  • NPI 1134317779
  Medicare reassignment NPD
• Foothills Sports Medicine & Rehabilitation, LLC

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1558318170
  Medicare reassignment NPD
• Foothills Sports Medicine & Rehabilitation, LLC

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1073224267
  NPD
• Foothills Sports Medicine & Rehabilitation, LLC

  • Physical Therapist
  • Tucson, AZ
  • NPI 1699405050
  NPD

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1720711971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15410 S MOUNTAIN PKWY STE 112",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850446691",
            "telephone_number": "480-410-4727",
            "fax_number": "480-706-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 N DYSART RD STE 148",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403062",
            "telephone_number": "623-547-4739",
            "fax_number": "623-536-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTERS",
        "first_name": "JEREMY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melinda Marie Williams, SLPA
• Phonemany Mary Williams, LPN
• Taylor Wilson, RBT
• Windrose Assisted Living
• Elena Wolfley, ATC
• Kenneth Wong, DDS
• Keri S. Wong, M.D.
• Antwon Woodcox
• Anissa Woodruff, RBT
• Jessica S Woods, COTA

• Physical Therapist in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.