Jared S. Anderson, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11689PT Issued in AZ

Practice address

2005 W Happy Valley Rd
Suite 170
Phoenix, AZ 85085-2893

Phone

(623) 322-0654

Fax

(623) 322-0664

NPI assigned

Sep 14, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, ID2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shellman Inc PAGroup PAC ID 4981592938, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Shellman Inc PA

  dba North Idaho Physical Therapy

  • Physical Therapist
  • Coeur D Alene, ID
  • NPI 1326050253
  Medicare reassignment Care Compare group NPD
• Ati Holdings of Arizona, LLC

  dba ATI Physical Therapy

  • Physical Therapist
  • Phoenix, AZ
  • NPI 1871570309
  Medicare reassignment

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1912375494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 N LAKEWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142634",
            "telephone_number": "208-763-0485",
            "fax_number": "844-955-2492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 W HAPPY VALLEY RD",
            "address_2": "SUITE 170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850852893",
            "telephone_number": "623-322-0654",
            "fax_number": "623-322-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JARED",
        "middle_name": "S.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-14",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11689PT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Anderson, NMD
• Jacob Scott Anderson, D.O.
• James Devin Anderson, DPM
• Jana Anderson, RPH
• Jared Anderson, O.D.
• Jason Anderson
• Jay Wesley Anderson, MD
• Jeanne Ellen Anderson, F.N.P.
• Jennifer Frances Anderson, MT-BC, NMT FELLOW
• Jesse Anderson, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.