Active NPI
Freddy Ruiz Jr.
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1104318344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- LPT-30940
- Practice address
- 17233 N Holmes Blvd Ste 1650
Phoenix, AZ 85053-2030 - Phone
- (602) 547-1836
- NPI assigned
- Jun 4, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | CA | ||
| Physical Therapist | 225100000X | LPT-30940 | AZ | Primary |
Addresses
Primary practice location
17233 N Holmes Blvd Ste 1650
Phoenix, AZ 85053-2030
Mailing address
17233 N Holmes Blvd Ste 1650
Phoenix, AZ 85053-2030
Phone (602) 547-1836
Other practice location 1
1333 Camino Del Rio S
San Diego, CA 92108-3520
Phone (619) 501-2195
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPT-30940 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strength Training Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Customized Equipment (DME)
- Phoenix, AZ
- NPI 1356552996
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1104318344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17233 N HOLMES BLVD STE 1650",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850532030",
"telephone_number": "602-547-1836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17233 N HOLMES BLVD STE 1650",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850532030",
"telephone_number": "602-547-1836"
}
],
"practiceLocations": [
{
"address_1": "1333 Camino Del Rio S",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921083520",
"country_code": "US",
"telephone_number": "619-501-2195",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUIZ",
"first_name": "FREDDY",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-04",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "LPT-30940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.