Individual provider Active NPI

Scott Ronald Richardson, MPT

  • Physical Therapist
  • Glendale, AZ
National Provider Identifier
1730117771
Registry record updated Oct 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2353 Issued in AZ
Practice address
18301 N 79TH Ave
Suite B122
Glendale, AZ 85308-8463
Phone
(623) 486-3333
Fax
(623) 486-3355
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2010

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 2353 AZ Primary

Addresses

Primary practice location

18301 N 79TH Ave
Suite B122
Glendale, AZ 85308-8463

Mailing address

18301 N 79TH Ave
Suite B122
Glendale, AZ 85308-8463
Phone (623) 486-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Preferred Physical Therapy, LLC Physical Therapist PastSince May 1, 2015 Accepting new patients
Enhanced Physical Therapy Physical Therapist PastSince Jan 1, 2003 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287619200000",
    "number": "1730117771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE",
            "address_2": "SUITE B122",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088463",
            "telephone_number": "623-486-3333",
            "fax_number": "623-486-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE",
            "address_2": "SUITE B122",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088463",
            "telephone_number": "623-486-3333",
            "fax_number": "623-486-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "SCOTT",
        "middle_name": "RONALD",
        "name_prefix": "Mr.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2010-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "2353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2010; 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.