Active NPI
CT Reatherford
- Mechanotherapist
- Cottonwood, AZ
National Provider Identifier
1215319462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mechanotherapist
- License
- MT-20747
- Practice address
- 3771 E Carol LN
Cottonwood, AZ 86326-5679 - Phone
- (602) 309-4158
- NPI assigned
- Jun 24, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mechanotherapist | 172M00000X | MT-20747 | AZ | Primary |
Addresses
Primary practice location
3771 E Carol LN
Cottonwood, AZ 86326-5679
Mailing address
3771 E Carol LN
Cottonwood, AZ 86326-5679
Phone (602) 309-4158
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 |
|---|---|---|---|
| MT-20747 | AZ | MD | Mechanotherapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435104000000",
"number": "1215319462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3771 E CAROL LN",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863265679",
"telephone_number": "602-309-4158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3771 E CAROL LN",
"city": "COTTONWOOD",
"state": "AZ",
"postal_code": "863265679",
"telephone_number": "602-309-4158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REATHERFORD",
"first_name": "CT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-24",
"last_updated": "2015-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "172M00000X",
"taxonomy_group": "",
"desc": "Mechanotherapist",
"state": "AZ",
"license": "MT-20747",
"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 Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.