Individual provider Active NPI

Eric Shultz, PTA

  • Physical Therapy Assistant
  • Sedona, AZ
National Provider Identifier
1801566633
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-014351 Issued in AZ
Practice address
55 Southwest Dr
Sedona, AZ 86336-3723
Phone
(928) 282-5050
NPI assigned
Sep 14, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X PTA-014351 AZ Primary

Addresses

Primary practice location

55 Southwest Dr
Sedona, AZ 86336-3723

Mailing address

148 Rainbow Dr # 4875
Livingston, TX 77399-1048
Phone (509) 581-9656

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA-014351AZMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lebec Physical Therapy PC Dba Lebec Physical Therapy Single Specialty CurrentSince Sep 23, 2021 Accepting new patients
Sedona Physical Therapy, LLC Single Specialty CurrentSince Sep 23, 2021 Accepting new patients

Locations

55 Southwest Dr
Sedona, AZ 86336
Phone (928) 282-5050

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": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1801566633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 RAINBOW DR # 4875",
            "city": "LIVINGSTON",
            "state": "TX",
            "postal_code": "773991048",
            "telephone_number": "509-581-9656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 SOUTHWEST DR",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863363723",
            "telephone_number": "928-282-5050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "ERIC",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "AZ",
            "license": "PTA-014351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedona, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.