Jared David Ricks

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

120910 Issued in TX

Practice address

9502 Novacek Blvd
San Antonio, TX 78254-2121

Phone

(208) 360-9969

Fax

(325) 261-8773

NPI assigned

Jan 7, 2020

Last updated

Feb 1, 2024By the provider in NPPES

Sex

Male

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

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.

• Canyon Kids Therapy LLC

  dba Canyon Kids Therapy

  • Pediatric Occupational Therapist
  • San Antonio, TX
  • NPI 1033986294

  Pediatrics

  NPD Authorized official
• Speech Blossoms LLC

  • Speech-Language Pathologist
  • Pocatello, ID
  • NPI 1285125203

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1578355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1619517711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9502 NOVACEK BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782542121",
            "telephone_number": "208-360-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9502 NOVACEK BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782542121",
            "telephone_number": "208-360-9969",
            "fax_number": "325-261-8773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1448 E Center St Ste I",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832014132",
            "country_code": "US",
            "telephone_number": "208-547-7145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICKS",
        "first_name": "JARED",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-07",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "120910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Rickards, PHARMD
• Roy Clifford Ricker, D.MIN
• Averess Dean Rickerson, M.D
• Stephanie Mariana Rickerson
• David Nathan Rickey, DDS
• Najalia Ricks
• Grecia Fernanda Rico Riberoll, MD
• Christina Victoria Rico-Garza, NP-C
• Dennie Ella Rico-Palomo, LVN
• Amaris Rico

• Pediatric Occupational Therapist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.