Donna Louise Crikos, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT11908 Issued in CA

Practice address

121 Boatyard Dr
Ste a
Fort Bragg, CA 95437-5751

Phone

(707) 964-1208

Fax

(707) 964-2269

NPI assigned

Jun 8, 2005

Last updated

Oct 22, 2007By the provider in NPPES

Sex

Female

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pacific Physical Therapy Inc.

  • Physical Therapist
  • Fort Bragg, CA
  • NPI 1548264492
  NPD (past)

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1891799797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2740",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954372740",
            "telephone_number": "707-964-6848",
            "fax_number": "707-964-2269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BOATYARD DR",
            "address_2": "STE A",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375751",
            "telephone_number": "707-964-1208",
            "fax_number": "707-964-2269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIKOS",
        "first_name": "DONNA",
        "middle_name": "LOUISE",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT11908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0119080",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Ernest Cottle Jr., D.O.
• County of Mendocino
• County of Mendocino
• Courtney Morgan Cravens, MPH, PA-C
• Sean Crawford
• Cynthia Audo
• Andrea D'Souza
• Edgar Damian
• Brandyn Alisa Davis, ASW
• Hallie J Davrill, LMFT

• Physical Therapist in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.