Individual provider Active NPI

Brittany Ricciardi, DPT

  • Physical Therapist
  • Goodyear, AZ
National Provider Identifier
1689067811
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11452 Issued in AZ
Practice address
14535 W Indian School Rd Suite 100
Goodyear, AZ 85395-9262
Phone
(623) 242-6908
NPI assigned
Mar 12, 2015
Last updated
Oct 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 11452 AZ Primary

Addresses

Primary practice location

14535 W Indian School Rd Suite 100
Goodyear, AZ 85395-9262

Mailing address

14430 N 41St CT
Phoenix, AZ 85032-5411

Other names 1

  • Brittany Deroche Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201021000471 AZ Practitioner - Physical Therapist in Private Practice 7810317419 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11452AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona Orthopedic Physical Therapy, PLLC CurrentSince Mar 1, 2020 Accepting new patients
Landmark Physical Therapy, PLLC Physical Therapist Past Accepting new patients

Locations

23350 W Yuma Rd
Buckeye, AZ 85326
Phone (623) 547-5260

14535 W Indian School Rd
Ste 100
Goodyear, AZ 85395
Phone (623) 734-5544

14557 W Indian School Rd
Ste 500
Goodyear, AZ 85395
Phone (623) 229-7808

14557 W Indian School Rd
Ste 500B
Goodyear, AZ 85395

2302 N 15th Ave
Phoenix, AZ 85007
Phone (602) 265-4124

2650 E McDowell Rd
Phoenix, AZ 85008
Phone (508) 638-1172

1781 E State Route 69
Ste 28
Prescott, AZ 86301

Organizations & group practices 2

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": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1689067811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14430 N 41ST CT",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14535 W INDIAN SCHOOL RD SUITE 100",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853959262",
            "telephone_number": "623-242-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICCIARDI",
        "first_name": "BRITTANY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "11452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRITTANY",
            "last_name": "DEROCHE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.