Individual provider Active NPI

Ryan David Parker

  • Physical Therapist
  • Casa Grande, AZ
National Provider Identifier
1407719735
Registry record updated Sep 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-035018 Issued in AZ
Practice address
1828 E Florence Blvd Ste 102
Casa Grande, AZ 85122-4783
Phone
(520) 510-0360
Fax
(520) 858-0174
NPI assigned
Dec 4, 2025
Last updated
Sep 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 054917 NY
Physical Therapist 225100000X LPT-035018 AZ Primary
Physical Therapist 225100000X P24582 NC

Addresses

Primary practice location

1828 E Florence Blvd Ste 102
Casa Grande, AZ 85122-4783

Mailing address

1828 E Florence Blvd Ste 102
Casa Grande, AZ 85122-4783
Phone (520) 510-0360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260120003709 NC Practitioner - Physical Therapist in Private Practice 5193202208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1991 Fordham Dr
Suite 102
Fayetteville, NC 28304-3774
Phone (910) 484-4653

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054917NYMDPharmacist
P24582NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cape Fear Valley Health Medical Group LLC Physical Therapist CurrentSince Jan 7, 2026 Accepting new patients
Cape Fear Valley Health Medical Group LLC CurrentSince Jan 7, 2026 Accepting new patients

Locations

1991 Fordham Dr
Ste 102
Fayetteville, NC 28304
Phone (910) 484-4653

Organizations & group practices 3

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": "1764806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1407719735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1828 E FLORENCE BLVD STE 102",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224783",
            "telephone_number": "520-510-0360",
            "fax_number": "520-858-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1828 E FLORENCE BLVD STE 102",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851224783",
            "telephone_number": "520-510-0360",
            "fax_number": "520-858-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "RYAN",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-12-04",
        "last_updated": "2026-09-29",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "054917",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-035018",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P24582",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.