Individual provider Active NPI

Dennis L Prickett, PT

  • Physical Therapist
  • Las Cruces, NM
National Provider Identifier
1336142744
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1147 Issued in NM
Practice address
1115 Commerce Dr
Suite C
Las Cruces, NM 88011
Phone
(575) 525-2450
Fax
(575) 522-9075
NPI assigned
May 31, 2005
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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 1147 NM Primary

Addresses

Primary practice location

1115 Commerce Dr
Suite C
Las Cruces, NM 88011

Mailing address

1115 Commerce Dr
Suite C
Las Cruces, NM 88011-8247
Phone (575) 525-2450

Other identifiers 1

IdentifierTypeStateIssuer
K8214MedicaidNM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090713000489 NM Practitioner - Physical Therapist in Private Practice 5890847412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrium Physical Therapy, Inc.Group PAC ID 5991857518, 2 clinicians

Practice addresses (Care Compare)

1115 Commerce Dr
Suite C
Las Cruces, NM 88011-8248
Phone (575) 525-2450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1147NMMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Atrium Physical Therapy, Inc. Physical Therapist CurrentSince May 7, 2009 Accepting new patients

Locations

1115 Commerce Dr
Ste C
Las Cruces, NM 88011
Phone (505) 525-2450

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1117497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1336142744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 COMMERCE DR",
            "address_2": "SUITE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880118247",
            "telephone_number": "575-525-2450",
            "fax_number": "575-522-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 COMMERCE DR",
            "address_2": "SUITE C",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88011",
            "telephone_number": "575-525-2450",
            "fax_number": "575-522-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRICKETT",
        "first_name": "DENNIS",
        "middle_name": "L",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-31",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "1147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "K8214",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.