NPIMap

Organization Active NPI

Resource Physical Therapy

  • Physical Therapist
  • Cottonwood, AZ
National Provider Identifier
1174661185
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RESOURCE PHYSICAL THERAPY
Practice address
825 W Mingus Ave
Cottonwood, AZ 86326-4088
Phone
(928) 639-3068
Fax
(928) 639-3346
NPI assigned
Feb 2, 2007
Last updated
Nov 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Mrs. Sandra Marie Hetrick
Title
Office Manager
Phone
(928) 639-3068

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

825 W Mingus Ave
Cottonwood, AZ 86326-4088

Mailing address

PO Box 2024
Cottonwood, AZ 86326-2024
Phone (928) 639-3068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040318001288 AZ Part B Supplier - Clinic/Group Practice 0547150864 Receives reassigned benefits from 1 practitioner
Practice locations: Cottonwood, AZ; Sedona, AZ

National Provider Directory

National Provider Directory
Tax ID family
Resource Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

257 Justin Dr
Ste A
Cottonwood, AZ 86326
Phone (928) 639-3068

657 E Cottonwood St
Ste 3D
Cottonwood, AZ 86326

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1174661185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2024",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863262024",
            "telephone_number": "928-639-3068",
            "fax_number": "928-639-3346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W MINGUS AVE",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264088",
            "telephone_number": "928-639-3068",
            "fax_number": "928-639-3346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESOURCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "HETRICK",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "928-639-3068",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.