Alicia Ray, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6627 Issued in MN

Practice address

622 Aberdeen Ave
Jordan, MN 55352-9516

Phone

(952) 492-2220

Fax

(952) 492-2073

NPI assigned

Feb 28, 2007

Last updated

Apr 11, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

Practice roles

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.

• Eagle Creek Chiropractic

  • Physical Therapist
  • Prior Lake, MN
  • NPI 1073847554
  NPD (past)
• Eagle Creek Wellness Center LLC

  • Chiropractor
  • Prior Lake, MN
  • NPI 1366631244
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1073641304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 HICKORY PL",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553521858",
            "telephone_number": "612-889-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 ABERDEEN AVE",
            "city": "JORDAN",
            "state": "MN",
            "postal_code": "553529516",
            "telephone_number": "952-492-2220",
            "fax_number": "952-492-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "ALICIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hollie Penney, D.C.
• Scott Charles Penney, D.C.
• Liza Antoinette Jain Phu, M.D.
• Amanda Preiner, OTR/L
• Kiirsten Rakers, BS
• Ruby Sky Therapy and Wellness
• Karis Rygg, LAC
• Lydia Schmidt, D.C.
• Ashtyn Silva, CPM, LTM
• Susan Leigh Smith Brunes

• Physical Therapist in Jordan, MN
• Providers in Jordan, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; 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.