Individual provider Active NPI

Emily Elizabeth Nettleton, PT, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1912784141
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33193 Issued in AZ
Practice address
16611 S 40TH St Ste 130
Phoenix, AZ 85048-0564
Phone
(480) 706-1199
NPI assigned
Sep 12, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 33193 AZ Primary

Addresses

Primary practice location

16611 S 40TH St Ste 130
Phoenix, AZ 85048-0564

Mailing address

16611 S 40TH St Ste 130
Phoenix, AZ 85048-0564
Phone (480) 706-1199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230926000151 AZ Practitioner - Physical Therapist in Private Practice 3971957994 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Creighton University School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spooner Physical Therapy and Hand Rehab, PCGroup PAC ID 3476440447, 202 clinicians

Practice addresses (Care Compare)

16611 S 40TH St
Suite 130
Phoenix, AZ 85048-0564
Phone (480) 706-1199

250 N Litchfield Rd
Suite 155
Goodyear, AZ 85338-1367
Phone (623) 882-9787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33193AZMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince Sep 2, 2023 Accepting new patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince Sep 2, 2023 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Past Accepting new patients

Locations

16611 S 40th St
Ste 130
Phoenix, AZ 85048
Phone (480) 706-1199

9097 E Desert Cove Ave
Ste 110
Scottsdale, AZ 85260
Phone (480) 860-4298

14287 N 87th St
Ste 220
Scottsdale, AZ 85260

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1694476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1912784141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16611 S 40TH ST STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480564",
            "telephone_number": "480-706-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16611 S 40TH ST STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850480564",
            "telephone_number": "480-706-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTLETON",
        "first_name": "EMILY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-12",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "33193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.