Ericson Sariego Bacsa, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 1409 Issued in AR

Practice address

2701 S Caraway Rd
Suite B2
Jonesboro, AR 72401-7304

Phone

(870) 919-4097

Fax

(870) 910-0245

NPI assigned

Aug 2, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Esb Rehab Services Inc.

  • Physical Therapist
  • Jonesboro, AR
  • NPI 1376551325
  NPD (past) Authorized official
• Esb Rehab Services Inc.

  • Specialist
  • Jonesboro, AR
  • NPI 1548240781
  NPD (past) Authorized official

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538176268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 S CARAWAY RD",
            "address_2": "SUITE B2",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017304",
            "telephone_number": "870-919-4097",
            "fax_number": "870-910-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 S CARAWAY RD",
            "address_2": "SUITE B2",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724017304",
            "telephone_number": "870-919-4097",
            "fax_number": "870-910-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACSA",
        "first_name": "ERICSON",
        "middle_name": "SARIEGO",
        "name_prefix": "Mr.",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT 1409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "5U937",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathaniel Ayers
• Trichina Ayers, MHPP
• Back in Action of Jonesboro, Inc.
• Dominique Leigh Bacot
• Maxwell Bacot, DO
• Courtney Lyn Bader
• Nathaniel Baggett, OD
• Justin Michael Baggs, M.D.
• Karen Baggs
• Amy Elizabeth Bailey, MD

• Physical Therapist in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.