Active NPI
Sandra Glick-Ridley, MSPT
- Physical Therapist
- Flagstaff, AZ
National Provider Identifier
1114160363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8441
- Practice address
- 120 W Fine Ave
Flagstaff, AZ 86001-3016 - Phone
- (928) 773-9695
- Fax
- (928) 773-0208
- NPI assigned
- Apr 16, 2009
- 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 | 8441 | AZ | Primary |
Addresses
Primary practice location
120 W Fine Ave
Flagstaff, AZ 86001-3016
Mailing address
120 W Fine Ave
Flagstaff, AZ 86001-3016
Phone (928) 773-9695
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 |
|---|---|---|---|
| 8441 | AZ | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northland-Rural Therapy Associates, LLC | Physical Therapist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318896000000",
"number": "1114160363",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 W FINE AVE",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013016",
"telephone_number": "928-773-9695",
"fax_number": "928-773-0208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 W FINE AVE",
"city": "FLAGSTAFF",
"state": "AZ",
"postal_code": "860013016",
"telephone_number": "928-773-9695",
"fax_number": "928-773-0208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GLICK-RIDLEY",
"first_name": "SANDRA",
"name_prefix": "Ms.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-16",
"last_updated": "2011-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "8441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flagstaff, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.