Mikaila Renae Caraveo Ruiz, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA-013815 Issued in AZ

Practice address

520 Rose LN
Wickenburg, AZ 85390-1447

Phone

(928) 684-5529

NPI assigned

Apr 22, 2019

Last updated

Apr 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1033772355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4533 S 236TH DR",
            "city": "BUCKEYE",
            "state": "AZ",
            "postal_code": "853267431",
            "telephone_number": "623-606-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 ROSE LN",
            "city": "WICKENBURG",
            "state": "AZ",
            "postal_code": "853901447",
            "telephone_number": "928-684-5529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARAVEO RUIZ",
        "first_name": "MIKAILA",
        "middle_name": "RENAE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-22",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-013815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Wickenburg, AZ
• Providers in Wickenburg, AZ by specialty
• Physical Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.