Organization Active NPI

Pelletier Rickert Physical Therapy, Inc., P.a.

  • Physical Therapist
  • Cape Coral, FL
National Provider Identifier
1255302824
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PELLETIER RICKERT PHYSICAL THERAPY, INC., P.A.
Practice address
1240 SE 8TH Ter
Cape Coral, FL 33990-3210
Phone
(239) 772-3335
Fax
(239) 772-9267
NPI assigned
Jan 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Lawrence R Rickert, PT
Title
PT/Owner
Phone
(239) 772-3335

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1240 SE 8TH Ter
Cape Coral, FL 33990-3210

Mailing address

1240 SE 8TH Ter
Cape Coral, FL 33990-3210
Phone (239) 772-3335

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041013000823 FL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 1759341860 Receives reassigned benefits from 3 practitioners
Practice locations: Cape Coral, FL; Bookelia, FL

National Provider Directory

National Provider Directory

Locations

5990 Mackerel Rd
Bokeelia, FL 33922
Phone (239) 283-1716

1240 SE 8th Ter
Cape Coral, FL 33990
Phone (239) 772-3335

Practitioners & affiliated clinicians

Practitioners 4

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": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255302824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 SE 8TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903210",
            "telephone_number": "239-772-3335",
            "fax_number": "239-772-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 SE 8TH TER",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903210",
            "telephone_number": "239-772-3335",
            "fax_number": "239-772-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELLETIER RICKERT PHYSICAL THERAPY, INC., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RICKERT",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PT/OWNER",
        "authorized_official_telephone_number": "239-772-3335",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.