Individual provider Active NPI

Charles M Richey, PTA

  • Physical Therapy Assistant
  • Carlsbad, NM
National Provider Identifier
1114366218
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A-0949 Issued in NM
Practice address
128 S Canyon St
Carlsbad, NM 88220-5733
Phone
(575) 439-1397
Fax
(575) 437-2622
NPI assigned
Jun 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A-0949 NM Primary

Addresses

Primary practice location

128 S Canyon St
Carlsbad, NM 88220-5733

Mailing address

PO Box 2860
Alamogordo, NM 88311-2860
Phone (575) 439-1397

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A-0949NMMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1114366218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2860",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883112860",
            "telephone_number": "575-439-1397",
            "fax_number": "575-437-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 S CANYON ST",
            "city": "CARLSBAD",
            "state": "NM",
            "postal_code": "882205733",
            "telephone_number": "575-439-1397",
            "fax_number": "575-437-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHEY",
        "first_name": "CHARLES",
        "middle_name": "M",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-0949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carlsbad, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; 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.