Ashley Vandermoon Brennan, DPT
Individual provider Active NPI Physical Therapist · Chandler, AZ
NPI 1740539287 · NPPES record last updated May 25, 2015
Key facts
- NPI
- 1740539287
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 11464 (AZ)
- Practice address
- 719 N Criss St
Chandler, AZ 85226-2247 - Phone
- (309) 530-2048
- NPI assigned
- Aug 30, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151111001492 | AZ | Practitioner - Physical Therapist in Private Practice | 7416267018 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070017300 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Luna Care Physical Therapy, LLC | Physical Therapist | Current |
Accepting new patients |
| Arizona Mobile Therapy LLC | Physical Therapist | Current |
Accepting new patients |
Locations
14050 N 83rd Ave
Ste 290
Peoria, AZ 85381
Phone (623) 261-1362
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070017300 | IL | |
| Physical Therapist | 225100000X | 11464 | AZ | Yes |
Addresses
Primary practice location
719 N Criss St
Chandler, AZ 85226-2247
Mailing address
719 N Criss St
Chandler, AZ 85226-2247
Other providers in Chandler, AZ
- Alexis Jade Breeden
- Makenna Breeden
- Brehan King PC
- Brenaj Chiropractic Group LLC
- Brennan Dental
- Carol B Brennan
- James Elliott Brennan
- Jonathan Jay Brennan
- Brett F Sperbeck DDS PC
- Nicole Alexa Brewer
All providers in Chandler, AZ · Physical Therapist in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 25, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.