Active NPI
Laurie Ricciardi, PT DPT RDN
- Physical Therapist
- Matthews, NC
National Provider Identifier
1164748240
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- P13683
- Practice address
- 2404 Plantation Center Dr
Matthews, NC 28105-5299 - Phone
- (704) 847-9477
- NPI assigned
- Apr 14, 2010
- Reactivated
- Sep 21, 2017
- Last updated
- Mar 21, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | NU | ||
| Physical Therapist | 225100000X | P13683 | NC | Primary |
Addresses
Primary practice location
2404 Plantation Center Dr
Matthews, NC 28105-5299
Mailing address
3001 Spring Forest Rd
Raleigh, NC 27616-2815
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
| License | State | Type | Specialty |
|---|---|---|---|
| P13683 | NC | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553126400000",
"number": "1164748240",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 SPRING FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2404 PLANTATION CENTER DR",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281055299",
"telephone_number": "704-847-9477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICCIARDI",
"first_name": "LAURIE",
"credential": "PT DPT RDN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-14",
"last_updated": "2019-03-21",
"deactivation_date": "2013-06-27",
"reactivation_date": "2017-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "P13683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.