Active NPI
Richard Fike, PT
- Physical Therapist
- Carmichael, CA
National Provider Identifier
1073507109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT11140
- Practice address
- 4737 El Camino Ave
Carmichael, CA 95608-4938 - Phone
- (916) 487-3473
- Fax
- (916) 487-3483
- NPI assigned
- Sep 5, 2005
- Reactivated
- Mar 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | PT11140 | CA | Primary |
Addresses
Primary practice location
4737 El Camino Ave
Carmichael, CA 95608-4938
Mailing address
4737 El Camino Ave
Carmichael, CA 95608-4938
Phone (916) 487-3473
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ04666Z | Other | CA | BLUESHIELD GROUP PROVIDER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT11140 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288051200000",
"number": "1073507109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4737 EL CAMINO AVE",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956084938",
"telephone_number": "916-487-3473",
"fax_number": "916-487-3483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4737 EL CAMINO AVE",
"city": "CARMICHAEL",
"state": "CA",
"postal_code": "956084938",
"telephone_number": "916-487-3473",
"fax_number": "916-487-3483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FIKE",
"first_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-05",
"last_updated": "2010-10-26",
"deactivation_date": "2006-03-24",
"reactivation_date": "2006-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT11140",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUESHIELD GROUP PROVIDER",
"identifier": "ZZZ04666Z",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carmichael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.