Individual provider Active NPI

Richard Edward Zitnik Jr., MS, PT

  • Physical Therapist
  • Robertsdale, AL
National Provider Identifier
1861538738
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH2036 Issued in AL
Practice address
17773 Highway 104
Robertsdale, AL 36567
Phone
(251) 947-7930
Fax
(251) 947-7931
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PTH2036 AL Primary

Addresses

Primary practice location

17773 Highway 104
Robertsdale, AL 36567

Mailing address

17773 Highway 104
Robertsdale, AL 36567
Phone (251) 947-7930

Other identifiers 1

IdentifierTypeStateIssuer
51523746OtherALBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040915001175 AL Practitioner - Physical Therapist in Private Practice 9537133780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17773 State Hwy 104
Robertsdale, AL 36567

17773 State Hwy 104
Robertsdale, AL 36567-7050
Phone (251) 947-7930

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Zei, Inc. CurrentSince Sep 1, 2004 Accepting new patients
Encore Rehabilitation, Inc Physical Therapist Past Accepting new patients
Encore Rehabilitation, Inc. Physical Therapist Past Accepting new patients

Locations

17773 State Highway 104
Robertsdale, AL 36567
Phone (251) 947-4175

Organizations & group practices 3

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861538738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17773 HIGHWAY 104",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "36567",
            "telephone_number": "251-947-7930",
            "fax_number": "251-947-7931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17773 HIGHWAY 104",
            "city": "ROBERTSDALE",
            "state": "AL",
            "postal_code": "36567",
            "telephone_number": "251-947-7930",
            "fax_number": "251-947-7931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZITNIK",
        "first_name": "RICHARD",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH2036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51523746",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Robertsdale, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.