OrganizationActive
Az Fidelis PLLC
NPI 1558507657 · Physical Medicine & Rehabilitation Physician · Scottsdale, AZ
Provider details
- NPI number
- 1558507657
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Glen Halvorson, Ceo(877) 408-2488
- License
- 13423 (AZ)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7702 E Doubletree Ranch Rd
Ste 300
Scottsdale, AZ 85258-2129
Phone: (877) 408-2488
Fax: (866) 776-6641
Street-level locationGet directions
Mailing address
7702 E Doubletree Ranch Rd
Scottsdale, AZ 85258-2129
Registry dates
- Enumerated
- 2008-12-20
- Last updated
- 2012-03-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.