Individual provider Active NPI

Danielle Dupont, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1740825355
Registry record updated Apr 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-31920 Issued in AZ
Practice address
539 E Glendale Ave Ste 105
Phoenix, AZ 85020-4900
Phone
(602) 241-3145
Fax
(602) 241-3146
NPI assigned
Nov 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X KY
Physical Therapist 225100000X LPT-31920 AZ Primary

Addresses

Primary practice location

539 E Glendale Ave Ste 105
Phoenix, AZ 85020-4900

Mailing address

100 Aqua Way Apt 219
Newport, KY 41071-2553
Phone (859) 750-9834

Other practice location 1

560 S Loop Rd
Edgewood, KY 41017-3405
Phone (859) 301-2663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220118001481 AZ Practitioner - Physical Therapist in Private Practice 3870928328 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
Foothills Sports Medicine and Rehabilitation LLCGroup PAC ID 2668457979, 172 clinicians

Practice addresses (Care Compare)

15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691
Phone (480) 940-8299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPT-31920AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist Current Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Jul 12, 2022 Accepting new patients
Foothills Sports Medicine & Orthopaedics Phoenix, LLC Physical Therapist CurrentSince Sep 18, 2021 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Jul 12, 2022 Accepting new patients

Locations

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

539 E Glendale Ave
Ste 105
Phoenix, AZ 85020
Phone (602) 241-3145

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

Organizations & group practices 6

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": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1740825355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 AQUA WAY APT 219",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410712553",
            "telephone_number": "859-750-9834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 E GLENDALE AVE STE 105",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204900",
            "telephone_number": "602-241-3145",
            "fax_number": "602-241-3146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "560 S Loop Rd",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173405",
            "country_code": "US",
            "telephone_number": "859-301-2663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUPONT",
        "first_name": "DANIELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-31920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 22, 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.