360 Physical Therapy, LLC
Organization Active NPI Specialist · Fountain Hills, AZ
NPI 1811153992 · NPPES record last updated Sep 9, 2013
Key facts
- NPI
- 1811153992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 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
- Organization subpart
- No
Authorized official
- Name
- Mrs. Cheryl Brunin
- Title
- Adminstrative Operations
- Phone
- (480) 821-1997
Other NPIs on the same Medicare enrollment 16
Practitioners 27
-
Seaton Bonar, DPT
-
Alexander Brusnahan, DPT
-
Alicia J Peacock, DPT
-
Heather Peden, MPT
-
Jessica Buckley, DPT
-
Heather Swain, PT, DPT
-
Patricia N Barrack, MPT
-
Megan Begley, DPT
-
Michael Hacker, OT
-
Anthony Kuhl, DPT
-
Reginald R Marquez, P.T.
-
Robin McDaniel, DPT
-
Kimberly E. Morin, PT, DPT
-
Brian Moss, MPT
-
Kristen Olander, MSPT
-
Malorie Jeanne Pease, DPT
-
Michai Phonthibsvads, PT, DPT
-
Thomas K Spray, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
National Provider Directory
Locations
12545 N Saguaro Blvd
Fountain Hills, AZ 85268
Phone (480) 837-1530
3530 S Val Vista Dr
Ste 102
Gilbert, AZ 85297
Phone (480) 719-4750
6630 W Cactus Rd
Ste B112113
Glendale, AZ 85304
8322 E McDowell Rd
Ste 102
Scottsdale, AZ 85257
Phone (480) 941-4169
8670 E Shea Blvd
Scottsdale, AZ 85260
Phone (913) 522-9964
8670 E Shea Blvd
Ste 230
Scottsdale, AZ 85260
8322 E McDowell Rd
Ste 103
Scottsdale, AZ 85257
11340 W Bell Rd
Ste 101A
Surprise, AZ 85378
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | Yes |
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
Other providers in Fountain Hills, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2013. 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.