Distinct Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

DISTINCT PHYSICAL THERAPY, PLLC

Practice address

900 W Chandler Blvd Ste a-4
Chandler, AZ 85225-4908

Phone

(480) 887-8725

Fax

(480) 719-1531

NPI assigned

Mar 11, 2019

Organization subpart

No

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

Authorized official

Name

John A Lewis, DPTNPI 1720161730

Title

Owner/Physical Therapist

Phone

(480) 887-8725

Specialties & licenses 2

Addresses

Other names 1

• Distinct PT 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.

• John A. Lewis, DPT

  • Physical Therapist
  • Chandler, AZ
  • NPI 1720161730
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1552262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1851859664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 W CHANDLER BLVD STE A-4",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852254908",
            "telephone_number": "480-887-8725",
            "fax_number": "480-719-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 W CHANDLER BLVD STE A-4",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852254908",
            "telephone_number": "480-887-8725",
            "fax_number": "480-719-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCT PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-11",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "480-887-8725",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Distinct PT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.