Individual provider Active NPI

Rylee Sutton, PTA

  • Physical Therapy Assistant
  • Redlands, CA
National Provider Identifier
1194391458
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
51096 Issued in CA
Practice address
1235 Indiana CT Ste 107
Redlands, CA 92374-4540
Phone
(909) 566-3358
NPI assigned
May 27, 2021
Last updated
May 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225200000X 51096 CA Primary

Addresses

Primary practice location

1235 Indiana CT Ste 107
Redlands, CA 92374-4540

Mailing address

25769 Van Leuven St Apt 86
Loma Linda, CA 92354-2545
Phone (509) 301-9420

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
51096CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Starlight Therapy Center Inc CurrentSince Jun 22, 2021 Accepting new patients

Locations

1235 Indiana Ct
Ste 107
Redlands, CA 92374
Phone (909) 566-3358

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": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622073600000",
    "number": "1194391458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25769 VAN LEUVEN ST APT 86",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542545",
            "telephone_number": "509-301-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 INDIANA CT STE 107",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744540",
            "telephone_number": "909-566-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUTTON",
        "first_name": "RYLEE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "51096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; 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.