Individual provider Active NPI

Richard Henry Sanford, PTA

  • Physical Therapy Assistant
  • Yucca Valley, CA
National Provider Identifier
1497162416
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
10139 Issued in CA
Practice address
56299 29 Palms Hwy
Yucca Valley, CA 92284-2857
Phone
(760) 367-1743
NPI assigned
Jul 22, 2014
Last updated
Jul 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 10139 CA Primary

Addresses

Primary practice location

56299 29 Palms Hwy
Yucca Valley, CA 92284-2857

Mailing address

56299 29 Palms Hwy
Yucca Valley, CA 92284-2857
Phone (760) 367-1743

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
10139CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
H.D.P.R.G., Inc PastSince Aug 1, 2015 Accepting new patients

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": "1405987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1497162416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56299 29 PALMS HWY",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842857",
            "telephone_number": "760-367-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56299 29 PALMS HWY",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842857",
            "telephone_number": "760-367-1743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "RICHARD",
        "middle_name": "HENRY",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-22",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "10139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.