Individual provider Active NPI

Richard Sedillo, P.T.

  • Physical Therapist
  • Scottsdale, AZ
National Provider Identifier
1366622318
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
AZ3300 Issued in AZ
Practice address
16700 N Thompson Peak Pkwy
Suite 220
Scottsdale, AZ 85260-2384
Phone
(480) 629-4606
Fax
(480) 629-8511
NPI assigned
Nov 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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 AZ3300 AZ Primary

Addresses

Primary practice location

16700 N Thompson Peak Pkwy
Suite 220
Scottsdale, AZ 85260-2384

Mailing address

16700 N Thompson Peak Pkwy
Suite 220
Scottsdale, AZ 85260-2384
Phone (480) 629-4606

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
AZ3300AZMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1366622318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16700 N THOMPSON PEAK PKWY",
            "address_2": "SUITE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602384",
            "telephone_number": "480-629-4606",
            "fax_number": "480-629-8511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16700 N THOMPSON PEAK PKWY",
            "address_2": "SUITE 220",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852602384",
            "telephone_number": "480-629-4606",
            "fax_number": "480-629-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDILLO",
        "first_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-07",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "AZ3300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.