Edwin Dave Ricketts, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT 7710 Issued in CA

Practice address

6177 River Crest Dr
#A
Riverside, CA 92507-0728

Phone

(951) 653-4480

Fax

(951) 653-5051

NPI assigned

Mar 19, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Coast Spine Restoration Center IncGroup PAC ID 7214824648, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• West Coast Spine Restoration Center, Inc

  • Physical Therapist
  • Riverside, CA
  • NPI 1992887616

  Occupational Therapist

  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1395187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395187200000",
    "number": "1023435708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14033 MONTECITO DR",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR",
            "address_2": "#A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070728",
            "telephone_number": "951-653-4480",
            "fax_number": "951-653-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "EDWIN",
        "middle_name": "DAVE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-19",
        "last_updated": "2014-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT 7710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA BOARD OF OCCUPATIONAL THERAPY",
            "identifier": "OT7710",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terryl Richey
• Richie Tran, DMD Inc
• Bradley A. Richie, MD
• Anthony Joelewis Richmond
• Emily R Rickard, LMFT
• Marquell Ricks
• Sandy Lagina Ricks
• Laila Rida
• Andrea Riedelsheimer, LMFT
• Corinne Ries

• Occupational Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2014; 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.