Individual provider Active NPI

Joshua Jenks, DPT

  • Physical Therapist
  • Chandler, AZ
National Provider Identifier
1871040279
Registry record updated Jul 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305212458 Issued in VA
Practice address
1076 W Chandler Blvd
103
Chandler, AZ 85224-5225
Phone
(480) 821-1997
NPI assigned
Sep 2, 2016
Last updated
Jul 16, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12491 AZ
Physical Therapist 225100000X 2305212458 VA Primary

Addresses

Primary practice location

1076 W Chandler Blvd
103
Chandler, AZ 85224-5225

Mailing address

8644 Sudley Rd Ste 308
Manassas, VA 20110-4425
Phone (571) 292-9910

Other practice location 1

8644 Sudley Rd Ste 308
Manassas, VA 20110-4425
Phone (571) 292-9910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12491AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
360 Physical Therapy LLC Physical Therapist CurrentSince Sep 2, 2016 Accepting new patients
360 Physical Therapy, LLC Current Accepting new patients

Locations

1076 W Chandler Blvd
Ste 103
Chandler, AZ 85224
Phone 4808211997116

3530 S Val Vista Dr
Ste 102
Gilbert, AZ 85297
Phone (480) 719-4750

25229 S Sun Lakes Blvd
Ste 119
Sun Lakes, AZ 85248
Phone (480) 883-6734

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626393600000",
    "number": "1871040279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8644 SUDLEY RD STE 308",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104425",
            "telephone_number": "571-292-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1076 W CHANDLER BLVD",
            "address_2": "103",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245225",
            "telephone_number": "480-821-1997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8644 Sudley Rd Ste 308",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201104425",
            "country_code": "US",
            "telephone_number": "571-292-9910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENKS",
        "first_name": "JOSHUA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-02",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "12491",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305212458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.