Active NPI
Carol Ristau, PT
- Physical Therapist
- Phoenix, AZ
National Provider Identifier
1104967140
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 0510
- Practice address
- 1420 E Northern Ave
Phoenix, AZ 85020-4317 - Phone
- (602) 331-7330
- Fax
- (602) 331-7344
- NPI assigned
- Feb 11, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 0510 | AZ | Primary |
Addresses
Primary practice location
1420 E Northern Ave
Phoenix, AZ 85020-4317
Mailing address
3343 E Clarendon Ave
Phoenix, AZ 85018-5709
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 |
|---|---|---|---|
| 510 | AZ | MD | Naturopath |
| 0510 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269388800000",
"number": "1104967140",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3343 E CLARENDON AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850185709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 E NORTHERN AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850204317",
"telephone_number": "602-331-7330",
"fax_number": "602-331-7344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISTAU",
"first_name": "CAROL",
"name_prefix": "Ms.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-11",
"last_updated": "2010-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "0510",
"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 Mar 24, 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.