Jodie Cicco, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

010825 Issued in AZ

Practice address

1380 S Castle Dome Ave
Yuma, AZ 85365-2024

Phone

(928) 259-7758

NPI assigned

Jan 13, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Institute of Manual Physical Therapy PLLCGroup PAC ID 9234494501, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Institute of Manual Physical Therapy PLLC

  • Physical Therapy Clinic/Center
  • Yuma, AZ
  • NPI 1821538612

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1389571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683331200000",
    "number": "1508288317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10229 E 39TH WAY",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853655454",
            "telephone_number": "412-610-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 S CASTLE DOME AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853652024",
            "telephone_number": "928-259-7758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCO",
        "first_name": "JODIE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-13",
        "last_updated": "2023-05-06",
        "certification_date": "2023-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "010825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natakom Nash Chulamorkodt, MD
• Aaron J. Chun, M.D.
• Mahealani Carla Chun, SLPA
• Justin Church, DMD
• Kipp Owens Church, D.M.D
• City of Yuma
• Christianna J Clark
• Hugh Rock Clark, DDS
• Pamela Clark
• Rebecca Clark, FOSTER PARENT

• Physical Therapist in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2023; 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.