Ronald Earhart, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5294 Issued in AZ

Practice address

77 W Forest Ave
301
Flagstaff, AZ 86001-1479

Phone

(928) 214-2836

Fax

(928) 214-2837

NPI assigned

Jul 18, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Flagstaff Center for Bone and Joint Disorders

  • Orthopaedic Surgery Physician
  • Flagstaff, AZ
  • NPI 1205865169
  NPD (past)
• Resource Physical Therapy

  • Specialist
  • Cottonwood, AZ
  • NPI 1205890134
  NPD (past)

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616803200000",
    "number": "1104080118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 E COTTONWOOD ST",
            "address_2": "STE 3D",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264407",
            "telephone_number": "928-214-2836",
            "fax_number": "928-214-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE",
            "address_2": "301",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011479",
            "telephone_number": "928-214-2836",
            "fax_number": "928-214-2837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EARHART",
        "first_name": "RONALD",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-18",
        "last_updated": "2021-03-27",
        "certification_date": "2021-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5294",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "5294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "825458",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dynamic Interventions of Arizona, LLC
• Kimberly Dziewit
• E Medical Group of Arizona No 5 LLC
• E-Therapy
• E. Elizabeth Claxton MD, PC
• Michael Earl, M.D.
• Stephanie Earl, RPH., BCPS
• Regina Eason
• East Flagstaff Family Medicine LLC
• Ashley Christopher Eberson, PA-C

• Orthopedic Physical Therapist in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Orthopedic Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2021; 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.