Individual provider Active NPI

Chris Cardella, OT

  • Occupational Therapist
  • Goodyear, AZ
National Provider Identifier
1942652839
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH-009013 Issued in AZ
Practice address
790 N Estrella Pkwy Ste C
Goodyear, AZ 85338-9290
Phone
(602) 765-4348
Fax
(623) 233-6567
NPI assigned
Jul 5, 2016
Last updated
Nov 22, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 2879 NC
Occupational Therapist 225X00000X OTH-009013 AZ Primary

Addresses

Primary practice location

790 N Estrella Pkwy Ste C
Goodyear, AZ 85338-9290

Mailing address

300 W Clarendon Ave Ste 285
Phoenix, AZ 85013-3474
Phone (602) 277-3686

Other practice location 1

11200 Governor Manly Way
Raleigh, NC 27614-8599
Phone (919) 562-9410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221213002498 AZ Practitioner - Occupational Therapist in Private Practice 9234508276 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

790 N Estrella Pkwy
Suite C
Goodyear, AZ 85338-9290
Phone (602) 765-4348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2879NCMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
DHT Hand Therapy Limited Partnership Occupational Therapist CurrentSince Nov 1, 2022 Accepting new patients
DHT Hand Therapy Limited Partnership Occupational Therapist CurrentSince Nov 1, 2022 Accepting new patients
DHT Hand Therapy Limited Partnership Occupational Therapist Current Accepting new patients
DHT Hand Therapy Limited Partnership Past Accepting new patients

Locations

5757 W Thunderbird Rd
Ste E465
Glendale, AZ 85306
Phone (602) 393-4263

790 N Estrella Pkwy
Ste C
Goodyear, AZ 85338
Phone (602) 765-4348

1860 N 95th Ln
Ste 105
Phoenix, AZ 85037
Phone (623) 907-0828

300 W Clarendon Ave
Ste 285
Phoenix, AZ 85013
Phone (602) 277-3686

690 N Cofco Center Ct
Ste 260
Phoenix, AZ 85008
Phone (602) 279-6905

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, 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": "1467676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1942652839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W CLARENDON AVE STE 285",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850133474",
            "telephone_number": "602-277-3686",
            "fax_number": "602-279-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 N ESTRELLA PKWY STE C",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853389290",
            "telephone_number": "602-765-4348",
            "fax_number": "623-233-6567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11200 Governor Manly Way",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276148599",
            "country_code": "US",
            "telephone_number": "919-562-9410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARDELLA",
        "first_name": "CHRIS",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-05",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NC",
            "license": "2879",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-009013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 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.