Active NPI
Steven Richards
- Physical Therapist
- Kirtland, NM
National Provider Identifier
1043719198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5013
- Practice address
- 4206 Highway 64 Ste A1
Kirtland, NM 87417-9416 - Phone
- (505) 258-4175
- NPI assigned
- Feb 5, 2018
- Last updated
- Feb 5, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5013 | NM | Primary |
Addresses
Primary practice location
4206 Highway 64 Ste A1
Kirtland, NM 87417-9416
Mailing address
15 Apex Dr
Highland, IL 62249-1282
Phone (618) 441-0482
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
105 Chandler Ave
Apt B
London, OH 43140-1179
105 Chandler Ave Apt B
London, OH 43140-1641
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5013 | NM | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Pole Physical Therapy, Inc | Current | Accepting new patients |
Locations
157 Lewis St
North Pole, AK 99705
Phone (907) 488-4978
Organizations & group practices 2
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.
-
- Physical Therapy Clinic/Center
- Worthington, OH
- NPI 1629671003
-
- Orthopedic Physical Therapist
- North Pole, AK
- NPI 1639238694
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1517788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517788800000",
"number": "1043719198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 APEX DR",
"city": "HIGHLAND",
"state": "IL",
"postal_code": "622491282",
"telephone_number": "618-441-0482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4206 HIGHWAY 64 STE A1",
"city": "KIRTLAND",
"state": "NM",
"postal_code": "874179416",
"telephone_number": "505-258-4175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICHARDS",
"first_name": "STEVEN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-05",
"last_updated": "2018-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NM",
"license": "5013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirtland, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2018; 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.