Active NPI
Ricky Alicante Lazo
- Physical Therapist
- Durham, NC
National Provider Identifier
1255598272
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10650
- Practice address
- 4230 N Roxboro St
Durham, NC 27704-1826 - Phone
- (919) 477-9805
- NPI assigned
- May 19, 2008
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10650 | NC | Primary |
Addresses
Primary practice location
4230 N Roxboro St
Durham, NC 27704-1826
Mailing address
3306 Genlee Dr
Durham, NC 27704-1872
Phone (919) 597-8266
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 |
|---|---|---|---|
| 10650 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1255598272",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3306 GENLEE DR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277041872",
"telephone_number": "919-597-8266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4230 N ROXBORO ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277041826",
"telephone_number": "919-477-9805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZO",
"first_name": "RICKY",
"middle_name": "ALICANTE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "10650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.