Alexander Ricky Folsom, PTA, ATC

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PA5638 Issued in ME

Practice address

98 Bangor St Ste a
Houlton, ME 04730-1603

Phone

(207) 521-0200

Fax

(207) 521-0210

NPI assigned

Oct 22, 2019

Last updated

Jun 26, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County Physical Therapy, LLC

  • Physical Therapist
  • Caribou, ME
  • NPI 1386686616
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1316580491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 BANGOR ST STE A",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301603",
            "telephone_number": "207-521-0200",
            "fax_number": "207-521-0210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 BANGOR ST STE A",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047301603",
            "telephone_number": "207-521-0200",
            "fax_number": "207-521-0210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 North St",
            "address_purpose": "LOCATION",
            "city": "Presque Isle",
            "state": "ME",
            "postal_code": "047692240",
            "country_code": "US",
            "telephone_number": "207-769-2160",
            "fax_number": "207-769-2161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOLSOM",
        "first_name": "ALEXANDER",
        "middle_name": "RICKY",
        "credential": "PTA, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-22",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ME",
            "license": "PA5638",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ME",
            "license": "AT749",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Nicole Saucier Fitzpatrick, DPT
• Serenna J Fitzpatrick, PTA, LMT
• Theresa Flannery-Blachura, MSW
• Lois M Flewelling, LCPC
• Melissa Sue Flewelling, LCPC
• Colleen P Folsom, RN
• Lorraine Folsom, DPT
• Tammy Fortier, N.P.
• Kim Ellen Fox, RN
• Colleen C Frost

• Physical Therapy Assistant in Houlton, ME
• Providers in Houlton, ME by specialty
• Physical Therapy Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.