NPIMap

Organization Active NPI

360 Physical Therapy LLC

Doing business as 360 Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Glendale, AZ
National Provider Identifier
1841712908
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
360 PHYSICAL THERAPY LLC
Doing business as
360 Physical Therapy
Practice address
6630 W Cactus Rd Ste B112
Glendale, AZ 85304-1662
Phone
(480) 821-1997
Fax
(480) 782-5213
NPI assigned
Jul 11, 2017
Last updated
Jun 16, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Cheryl Brunin
Title
VP of Billing Operations
Phone
(480) 821-1997

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

6630 W Cactus Rd Ste B112
Glendale, AZ 85304-1662

Mailing address

1076 W Chandler Blvd Ste 103
Chandler, AZ 85224-5223
Phone (480) 821-1997

Other names 1

  • 360 Physical Therapy Doing business as

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
Tax ID family
360 Physical Therapy LLC15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

21083 N John Wayne Pkwy
Ste C104
Maricopa, AZ 85139
Phone (520) 233-7555

Practitioners & affiliated clinicians

Practitioners 5

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": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1841712908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD STE 103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245223",
            "telephone_number": "480-821-1997",
            "fax_number": "480-782-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 W CACTUS RD STE B112",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853041662",
            "telephone_number": "480-821-1997",
            "fax_number": "480-782-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-11",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "BRUNIN",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "VP OF BILLING OPERATIONS",
        "authorized_official_telephone_number": "480-821-1997"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "360 Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.