Individual provider Active NPI

Eric Michael Rippetoe, D.P.T.

  • Orthopedic Physical Therapist
  • Shreveport, LA
National Provider Identifier
1871931345
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
09574R Issued in LA
Practice address
717 Crockett St Ste 205
Shreveport, LA 71101-3605
Phone
(318) 333-1331
Fax
(318) 625-0704
NPI assigned
Jun 6, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 09574R LA Primary

Addresses

Primary practice location

717 Crockett St Ste 205
Shreveport, LA 71101-3605

Mailing address

9735 Aiello LN
Shreveport, LA 71106-7440
Phone (318) 560-5726

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231014000251 LA Practitioner - Physical Therapist in Private Practice 4486898913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
09574RLAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rippetoe Health Physical Therapist CurrentSince Mar 17, 2017 Accepting new patients
Chiropractic of Melissa PLLC PastSince Aug 11, 2024 Accepting new patients

Locations

717 Crockett St
Shreveport, LA 71101
Phone (318) 252-8839

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": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1871931345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9735 AIELLO LN",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711067440",
            "telephone_number": "318-560-5726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 CROCKETT ST STE 205",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013605",
            "telephone_number": "318-333-1331",
            "fax_number": "318-625-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIPPETOE",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-06",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "LA",
            "license": "09574R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.