Individual provider Active NPI

Robert Corey Addicott, P.T.

  • Orthopedic Physical Therapist
  • Glendale, AZ
National Provider Identifier
1881697597
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
5198 Issued in AZ
Practice address
20325 N 51St Ave Ste 150
Glendale, AZ 85308-4622
Phone
(602) 385-2115
Fax
(480) 418-3323
NPI assigned
May 27, 2005
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5198 AZ
Sports Physical Therapist 2251S0007X 5198 AZ
Orthopedic Physical Therapist 2251X0800X 5198 AZ Primary

Addresses

Primary practice location

20325 N 51St Ave Ste 150
Glendale, AZ 85308-4622

Mailing address

18444 N 25TH Ave
Suite 310
Phoenix, AZ 85023-1261
Phone (623) 537-5600

Other identifiers 2

IdentifierTypeStateIssuer
113252MedicaidAZ
69799OtherAZMEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111017000689 AZ Practitioner - Physical Therapist in Private Practice 1557533528 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20325 N 51St Ave
Suite 150
Glendale, AZ 85308-4622
Phone (602) 795-6300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5198AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Specialists of North America PLLC CurrentSince Aug 19, 2022 Accepting new patients
Orthopedic Specialists of North America, PLLC Current Accepting new patients
Orthopedic Specialists of North America, PLLC CurrentSince Aug 19, 2022 Accepting new patients
Center for Orthopedic Research and Education, LLC Physical Therapist Past Accepting new patients

Locations

18555 N 79th Ave
Ste E101
Glendale, AZ 85308
Phone (602) 631-3161

20325 N 51st Ave
Ste 150
Glendale, AZ 85308
Phone (602) 795-6300

2902 W Agua Fria Fwy
Ste 1090
Phoenix, AZ 85027
Phone (620) 648-5444

40601 N Gantzel Rd
Ste 103
San Tan Vly, AZ 85140

5620 E Bell Rd
Scottsdale, AZ 85254
Phone (602) 485-3050

Organizations & group practices 5

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": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1881697597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE",
            "address_2": "SUITE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231261",
            "telephone_number": "623-537-5600",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20325 N 51ST AVE STE 150",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084622",
            "telephone_number": "602-385-2115",
            "fax_number": "480-418-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDICOTT",
        "first_name": "ROBERT",
        "middle_name": "COREY",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5198",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "AZ",
            "license": "5198",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "5198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113252",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "69799",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Aug 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.