Jennifer Lynn Ratliff, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT17095 Issued in CA

Practice address

4216 Shasta Dam Blvd
Shasta Lake, CA 96019-9422

Phone

(530) 275-0777

Fax

(530) 275-8779

NPI assigned

Sep 6, 2007

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

State licenses

Practice roles

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

• Shasta Lake Physical Therapy

  • Physical Therapist
  • Shasta Lake, CA
  • NPI 1255376893
  NPD (past)

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1083809750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 493396",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960493396",
            "telephone_number": "530-221-9952",
            "fax_number": "530-221-9954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 SHASTA DAM BLVD",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960199422",
            "telephone_number": "530-275-0777",
            "fax_number": "530-275-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT17095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Shasta Lake, CA
• Providers in Shasta Lake, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.