Individual provider Active NPI

Jennifer Danielle McConnell, P.T.

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1952514366
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6252 Issued in AZ
Practice address
4141 E Thomas Rd
Phoenix, AZ 85018-7515
Phone
(602) 954-7742
Fax
(602) 955-2229
NPI assigned
May 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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 6252 AZ Primary

Addresses

Primary practice location

4141 E Thomas Rd
Phoenix, AZ 85018-7515

Mailing address

20830 N Tatum Blvd
Suite 115
Phoenix, AZ 85050-7256
Phone (480) 473-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040630000762 AZ Practitioner - Physical Therapist in Private Practice 8325025182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brian F Gruber MD LTDGroup PAC ID 5294046231, 8 clinicians

Practice addresses (Care Compare)

17300 N Perimeter Dr
Suite 150
Scottsdale, AZ 85255-6598
Phone (602) 734-1834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6252AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Luna Care Physical Therapy, LLC Physical Therapist CurrentSince Jul 19, 2024 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Rehab Plus Sports Conditioning, LLC Past Accepting new patients
Giardina Sportsmedicine Consultants, Inc. Physical Therapist PastSince Sep 6, 2005 Accepting new patients
Neurosurgical Associates, LTD Physical Therapist PastSince Aug 29, 2016 Accepting new patients

Locations

14050 N 83rd Ave
Ste 290
Peoria, AZ 85381
Phone (623) 261-1362

Organizations & group practices 7

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1952514366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20830 N TATUM BLVD",
            "address_2": "SUITE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850507256",
            "telephone_number": "480-473-1200",
            "fax_number": "480-473-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 E THOMAS RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187515",
            "telephone_number": "602-954-7742",
            "fax_number": "602-955-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "JENNIFER",
        "middle_name": "DANIELLE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6252",
            "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 Jan 18, 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.