NPIMap

Organization Active NPI

360 Physical Therapy, LLC

  • Specialist
  • Fountain Hills, AZ
National Provider Identifier
1811153992
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
360 PHYSICAL THERAPY, LLC
Practice address
12545 N Saguaro Blvd
Fountain Hills, AZ 85268-3857
Phone
(480) 837-1530
Fax
(480) 821-1887
NPI assigned
Jul 29, 2008
Last updated
Sep 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Authorized official

Name
Mrs. Cheryl Brunin
Title
Adminstrative Operations
Phone
(480) 821-1997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

12545 N Saguaro Blvd
Fountain Hills, AZ 85268-3857

Mailing address

12545 N Saguaro Blvd
Fountain Hills, AZ 85268-3857
Phone (480) 837-1530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040224000822 AZ Part B Supplier - Clinic/Group Practice 1355237645 Receives reassigned benefits from 144 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Phoenix, AZ; Queen Creek, AZ; Scottsdale, AZ; Sun Lakes, AZ; Surprise, AZ; Tempe, AZ; Goodyear, AZ; Mesa, AZ…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Locations

12545 N Saguaro Blvd
Fountain Hills, AZ 85268
Phone (480) 837-1530

13215 N Verde River Dr
Ste 5
Fountain Hills, AZ 85268
Phone (480) 837-1530

6630 W Cactus Rd
Ste B112113
Glendale, AZ 85304

8322 E McDowell Rd
Ste 103
Scottsdale, AZ 85257

8670 E Shea Blvd
Ste 230
Scottsdale, AZ 85260

11340 W Bell Rd
Ste 101A
Surprise, AZ 85378

Practitioners & affiliated clinicians

Practitioners 27

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.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378684800000",
    "number": "1811153992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12545 N SAGUARO BLVD",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683857",
            "telephone_number": "480-837-1530",
            "fax_number": "480-821-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12545 N SAGUARO BLVD",
            "city": "FOUNTAIN HILLS",
            "state": "AZ",
            "postal_code": "852683857",
            "telephone_number": "480-837-1530",
            "fax_number": "480-821-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2013-09-09",
        "status": "A",
        "authorized_official_last_name": "BRUNIN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "ADMINSTRATIVE OPERATIONS",
        "authorized_official_telephone_number": "480-821-1997",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Hills, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.