360 PHYSICAL THERAPY LLC — NPI 1154806065 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in MESA, AZ)

CMS-1500 Box 24J / 33a • NPI

1154806065

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QP2000X (CMS 70)

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

10861 E BASELINE RD STE A-105, MESA, AZ, 85209-7921

✓ 9-Digit EDI 837 ZIP+4 (85209-7921)

Practice Phone & Referral Fax

(480) 821-1997

Fax: (480) 821-2536

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1154806065 (360 PHYSICAL THERAPY LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1154806065` (NPI-2 Organization / Facility)
Provider / Legal Name	360 PHYSICAL THERAPY LLC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QP2000X` (Clinic/Center, Physical Therapy)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	10861 E BASELINE RD STE A-105, MESA, AZ, 85209-7921
Practice Telephone / Fax	Tel: (480) 821-1997 \| Fax: (480) 821-2536
Administrative Mailing Address	1076 W CHANDLER BLVD STE 103, CHANDLER, AZ, 85224-5223
Enumeration & Last Sync	Enumerated: 2018-09-26 \| CMS Record Updated: 2023-03-23
Authorized Official	CHERYL HUNNEL (VP of Billing Operations)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

10861 E BASELINE RD STE A-105, MESA, AZ, 85209-7921

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Plain-English Taxonomy & CMS Crosswalk (261QP2000X)

What Does Taxonomy Code 261QP2000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QP2000X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 70 (Clinic or Group Practice)
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (360 PHYSICAL THERAPY LLC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`225100000X` — Physical Therapist Plain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist	State: N/A \| License: `Verified` \| Primary: Secondary
`261QP2000X` — Clinic/Center, Physical Therapy Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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360 PHYSICAL THERAPY LLC (NPI #1154806065)