Organization Active NPI

Physical Therapy Complete PLLC

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1780651158
Registry record updated Nov 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PHYSICAL THERAPY COMPLETE PLLC
Practice address
375 E Virginia Ave
Suite B
Phoenix, AZ 85004-1220
Phone
(602) 264-5323
Fax
(602) 264-5302
NPI assigned
Mar 3, 2006
Last updated
Nov 27, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2007

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

Authorized official

Name
Mr. Paul John Gleason, P.T.NPI 1649247651
Title
Owner/Member
Phone
(602) 264-5323

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

375 E Virginia Ave
Suite B
Phoenix, AZ 85004-1220

Mailing address

375 E Virginia Ave
Suite B
Phoenix, AZ 85004-1220
Phone (602) 264-5323

Other identifiers 4

IdentifierTypeStateIssuer
854184MedicaidAZ
P0460470OtherAZBCBS OF ARIZONA
8145185OtherAZAETNA PROVIDER ID
2Z1876OtherAZHEALTHNET PROVIDER ID

National Provider Directory

National Provider Directory

Locations

2700 N 3rd St
#100
Phoenix, AZ 85004
Phone (602) 264-5323

375 E Virginia Ave
Ste B
Phoenix, AZ 85004
Phone (602) 264-0443

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196121600000",
    "number": "1780651158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 E VIRGINIA AVE",
            "address_2": "SUITE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041220",
            "telephone_number": "602-264-5323",
            "fax_number": "602-264-5302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 E VIRGINIA AVE",
            "address_2": "SUITE B",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041220",
            "telephone_number": "602-264-5323",
            "fax_number": "602-264-5302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY COMPLETE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2007-11-27",
        "status": "A",
        "authorized_official_last_name": "GLEASON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "602-264-5323",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "854184",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ARIZONA",
            "identifier": "P0460470",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "8145185",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PROVIDER ID",
            "identifier": "2Z1876",
            "state": "AZ"
        }
    ],
    "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 Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.