Rhett Shannan Patrick, MS, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT24157 Issued in CA

Practice address

10542 W Pico Blvd
Los Angeles, CA 90064-2332

Phone

(310) 838-3331

Fax

(310) 838-9992

NPI assigned

May 9, 2007

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Patrick Physical Therapy Inc

  • Physical Therapist
  • Sherman Oaks, CA
  • NPI 1497771885
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1609080043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10542 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642332",
            "telephone_number": "818-795-8917",
            "fax_number": "310-838-9992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10542 W PICO BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642332",
            "telephone_number": "310-838-3331",
            "fax_number": "310-838-9992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "RHETT",
        "middle_name": "SHANNAN",
        "name_prefix": "Mr.",
        "credential": "MS, MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT24157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Tully Licensed Marriage and Family Therapist Inc
• Angelina Patrick
• Candice Renee Patrick
• Carolyn Jeanette Patrick
• Kyra N/a Patrick
• Theresa Patrick
• Beatriz Patron
• Stephanie Patschull
• Sotirios Patsiadis
• Rugved Shrikant Pattarkine, MD

• Physical Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.