ADVANCED MEDICAL THERAPY LLC (NPI# 1093193716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093193716 |
| Entity Type | Organization |
| Organization Name | ADVANCED MEDICAL THERAPY LLC |
| Practice Address |
15640 N 7th St Ste 6 Phoenix AZ 85022-3538 |
| Mailing Address |
16075 W Lincoln St Goodyear AZ 85338-2828 |
| Practice Telephone | 6024393800 |
| Mailing Telephone | 2189660700 |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2015-05-14 |
| Authorized Official Name | HADDAR ICHILOV (ADMINISTRATOR) |
| Authorized Official Telephone | 6024393800 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
11525 | AZ | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144652199 | Advanced Medical Therapy LLC | Urology | 614 S Bloomington St, Streator, IL 61364-3306 | 2013-08-01 |
| Street Address |
15640 N 7TH ST STE 6 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85022-3538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467831073 | Ian Michael Larson | Physical Therapist | 15640 N 7th St Ste 6, Phoenix, AZ 85022-3538 | 2015-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528626074 | Keauna Olugu | Psychologist | 17249 N. 7th St, 1128, Phoenix, AZ 85022 | 2019-05-30 |
| 1215455498 | Kristi Etchechury | Occupational Therapy Assistant | 807 East Beck Lane, Phoenix, AZ 85022 | 2017-09-07 |
| 1871017103 | Julie Dale | Physical Therapist | 1910 E Kathleen Rd, Phoenix, AZ 85022 | 2017-07-28 |
| 1669994539 | Valley Wellness Center Pllc | Clinic/Center | 702 E Bell Rd Ste 112, Phoenix, AZ 85022 | 2017-07-12 |
| 1386001758 | Debbie Mulder | Behavioral Analyst | 2400 West Dunlap Ave., Suite 100, Glendale, AZ 85022 | 2016-01-15 |
| 1114383437 | Jean Fay King | Nurse Practitioner | 15409 N. 23rd St., Phoenix, AZ 85022 | 2016-01-04 |
| 1093050767 | Cheyanne Wilderness Gastelum | Midwife | 2236 E. Delgado St., Phoenix, AZ 85022 | 2012-12-06 |
| 1760731236 | Nicole Ann Raus | Occupational Therapy Assistant | 15414 N. 7th Street, Suite 3, Phoenix, AZ 85022 | 2012-08-30 |
| 1144593211 | Edward Najeeb Abraham | Family Medicine | 14419 N. 5th Place, Phoenix, AZ 85022 | 2012-02-20 |
| 1942506019 | Mirnes Mehic | Assisted Living Facility | 2018 E. Wagoner Rd., Phoenix, AZ 85022 | 2011-02-07 |
| Find all providers in zip 85022 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568079523 | Trailhead Health & Rehab LLC | Clinic/Center | 1838 W Parkside Ln Ste 110, Phoenix, AZ 85027-1370 | 2020-09-24 |
| 1649811498 | Urgentmed House Call LLC | Clinic/Center | 2224 W Clarendon Ave, Phoenix, AZ 85015-5435 | 2019-10-03 |
| 1750931267 | Life Clinic of Az PC | Clinic/Center | 2580 E Camelback Rd, Phoenix, AZ 85016-4204 | 2019-09-17 |
| 1831650431 | Best Performance & Therapy | Clinic/Center | 11042 N 24th Ave, Phoenix, AZ 85029-4777 | 2019-03-26 |
| 1356828511 | Foothills Therapy Partners, LLC | Clinic/Center | 4455 E Camelback Rd Bldg A, Phoenix, AZ 85018-2843 | 2018-07-20 |
| 1053801993 | Foothills Sports Medicine & Physical Therapy - Tatum Shea LLC | Clinic/Center | 11250 N Tatum Blvd, Phoenix, AZ 85028-2306 | 2018-05-16 |
| 1134632342 | Kernan Manual Physical Therapy, LLC | Clinic/Center | 3819 E Indian School Rd, Phoenix, AZ 85018-5234 | 2017-11-09 |
| 1164934667 | Katelyn A Crist | Clinic/Center | 2650 E Mcdowell Rd Ste 200, Phoenix, AZ 85008-3658 | 2017-10-25 |
| 1104278928 | Spooner Physical Therapy & Hand Rehab, PC | Clinic/Center | 717 W Dunlap Ave Ste 100, Phoenix, AZ 85021-3521 | 2016-07-05 |
| 1033511100 | Functional Investments, Pllc | Clinic/Center | 4303 W Van Buren St, Ste 4, Phoenix, AZ 85043-3928 | 2014-09-20 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.