Individual provider Active NPI

Reed L Pedrick, P.T.

  • Physical Therapist
  • Laramie, WY
National Provider Identifier
1194908194
Registry record updated Dec 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-0036 Issued in WY
Practice address
3125 E Grand Ave
Suite a
Laramie, WY 82070-5137
Phone
(307) 742-3110
NPI assigned
Dec 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-0036 WY Primary

Addresses

Primary practice location

3125 E Grand Ave
Suite a
Laramie, WY 82070-5137

Mailing address

3125 E Grand Ave
Suite a
Laramie, WY 82070-5137
Phone (307) 742-3110

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
PT-0036WYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pedrick Inc Physical Therapist Past Accepting new patients
Blair Investments Inc Physical Therapist PastSince Jul 18, 2011 Accepting new patients

Organizations & group practices 2

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": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197417600000",
    "number": "1194908194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3125 E GRAND AVE",
            "address_2": "SUITE A",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705137",
            "telephone_number": "307-742-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 E GRAND AVE",
            "address_2": "SUITE A",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "820705137",
            "telephone_number": "307-742-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRICK",
        "first_name": "REED",
        "middle_name": "L",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-0036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laramie, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; 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.