Arizona Physical Therapy Services of Cottonwood, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ARIZONA PHYSICAL THERAPY SERVICES OF COTTONWOOD, LLC

Doing business as

Arizona Physical Therapy Services of Cottonwood

Practice address

201 E Mingus Ave Apt 201
Cottonwood, AZ 86326-3679

Phone

(928) 202-3650

Fax

(928) 202-4687

NPI assigned

Oct 10, 2022

Last updated

May 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joshua L. Proffitt

Title

President

Phone

(337) 233-1307

Specialties & licenses 3

Addresses

Other names 1

• Arizona Physical Therapy Services of Cottonwood Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jonathon David Bodam, PT

  • Physical Therapist
  • Chandler, AZ
  • NPI 1811416233
  Medicare reassignment NPD

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1780309963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307",
            "fax_number": "337-443-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E MINGUS AVE APT 201",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863263679",
            "telephone_number": "928-202-3650",
            "fax_number": "928-202-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARIZONA PHYSICAL THERAPY SERVICES OF COTTONWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Arizona Physical Therapy Services of Cottonwood",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Arizona Physical Therapy Services of Cottonwood",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Cottonwood, AZ
• Providers in Cottonwood, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.