Individual provider Active NPI

Tanner Richey, PT

  • Physical Therapist
  • Lubbock, TX
National Provider Identifier
1285203828
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
3127342 Issued in TX
Practice address
5044 Frankford Ave
Lubbock, TX 79424-1146
Phone
(806) 792-7200
Fax
(806) 792-7225
NPI assigned
Jun 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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 3127342 TX Primary

Addresses

Primary practice location

5044 Frankford Ave
Lubbock, TX 79424-1146

Mailing address

4110 22ND PL
Lubbock, TX 79410-1122
Phone (806) 792-4329

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016001418 TX Practitioner - Physical Therapist in Private Practice 6103271838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CSK Medical PartnersGroup PAC ID 2466404447, 20 clinicians

Practice addresses (Care Compare)

5044 Frankford Ave
Suite 100
Lubbock, TX 79424-1146
Phone (806) 792-7200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3127342TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
CSK Medical Partners CurrentSince Sep 1, 2023 Accepting new patients
CSK Medical Partners CurrentSince Sep 1, 2023 Accepting new patients

Locations

5044 Frankford Ave
Ste 100
Lubbock, TX 79424
Phone (806) 792-7200

4110 22nd Pl
Lubbock, TX 79410
Phone (806) 792-4329

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": "1623974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1285203828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 22ND PL",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101122",
            "telephone_number": "806-792-4329",
            "fax_number": "806-792-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5044 FRANKFORD AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794241146",
            "telephone_number": "806-792-7200",
            "fax_number": "806-792-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHEY",
        "first_name": "TANNER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-18",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "3127342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.