Robert Ricketts, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

45606 Issued in CO

Practice address

3150 N 12TH St
Grand Junction, CO 81506-2863

Phone

(970) 245-1220

Fax

(970) 254-2398

NPI assigned

Nov 11, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1720069123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 N. 12TH ST.",
            "address_2": "P.O. BOX 10700",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815025517",
            "telephone_number": "970-245-1220",
            "fax_number": "970-254-2398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N 12TH ST",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815062863",
            "telephone_number": "970-245-1220",
            "fax_number": "970-254-2398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-11",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "45606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72854065",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirby K Richardson, OTR
• Laura Hope Richardson
• Robert Sean Richardson, PT
• Kathleen A Richmond, ORT-CERTIFIED
• Lisa Rickerd-Mills, MSW
• Bruce Marc Ricks, D.D.S.
• Roberta L Riddel, PT, DPT, CCI
• Amanda Leann Riddle, PHARM. D
• Judy Ridenour
• Ronald Dean Ridgley, D.O.

• Family Medicine Physician in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.