Individual provider Active NPI

Tanner Chitwood, DPT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1972097178
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30019 Issued in AZ
Practice address
5040 N 15TH Ave Ste 401
Phoenix, AZ 85015-3332
Phone
(602) 285-0949
Fax
(602) 285-0052
NPI assigned
Jun 20, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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 30019 AZ Primary

Addresses

Primary practice location

5040 N 15TH Ave Ste 401
Phoenix, AZ 85015-3332

Mailing address

14287 N 87TH St Ste 220
Scottsdale, AZ 85260-3698
Phone (602) 329-8250

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180720001013 AZ Practitioner - Physical Therapist in Private Practice 3870840986 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
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)

9097 E Desert Cove Ave
Suite 110
Scottsdale, AZ 85260-6276
Phone (480) 924-5514

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30019AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spooner Physical Therapy & Hand Rehab, PC CurrentSince Sep 1, 2018 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Current Accepting new patients
Spooner Physical Therapy and Hand Rehab, PC Physical Therapist CurrentSince Sep 1, 2018 Accepting new patients
Spooner Physical Therapy & Hand Rehab, PC Current Accepting new patients
Spooner Phoenix Physical Therapy, Inc. Physical Therapist CurrentSince Jul 1, 2018 Accepting new patients
KC'S Physical Therapy LLC Past Accepting new patients

Locations

7931 E Pecos Rd
Ste 104
Mesa, AZ 85212
Phone (480) 682-5460

303 E Baseline Rd
Ste 110
Phoenix, AZ 85042
Phone (602) 243-1476

5040 N 15th Ave
Ste 401
Phoenix, AZ 85015
Phone (602) 274-9811

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 6

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1972097178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14287 N 87TH ST STE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603698",
            "telephone_number": "602-329-8250",
            "fax_number": "480-565-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 N 15TH AVE STE 401",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153332",
            "telephone_number": "602-285-0949",
            "fax_number": "602-285-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHITWOOD",
        "first_name": "TANNER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-20",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "30019",
            "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 Feb 23, 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.