Active NPI
Richa S Vaidya, PHYSICAL THERAPIST
- Physical Therapist
- Prophetstown, IL
National Provider Identifier
1902329212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070.022681
- Practice address
- 701 E 3Rd St
Prophetstown, IL 61277-1334 - Phone
- (847) 347-5254
- NPI assigned
- Jul 18, 2017
- Last updated
- Jul 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070.022681 | IL | Primary |
Addresses
Primary practice location
701 E 3Rd St
Prophetstown, IL 61277-1334
Mailing address
4433 Tranquility TRL
Bettendorf, IA 52722-1242
Phone (847) 347-5254
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070.022681 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1500336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1500336000000",
"number": "1902329212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4433 TRANQUILITY TRL",
"city": "BETTENDORF",
"state": "IA",
"postal_code": "527221242",
"telephone_number": "847-347-5254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 E 3RD ST",
"city": "PROPHETSTOWN",
"state": "IL",
"postal_code": "612771334",
"telephone_number": "847-347-5254"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAIDYA",
"first_name": "RICHA",
"middle_name": "S",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-07-18",
"last_updated": "2017-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.022681",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prophetstown, IL
- Prophetstown Lyndon Tampico Cu
- Rock Valley Physical Therapy Center
- Brooke Russell, D.P.T.
- Abigail M Temple, DPT
- The Evangelical Lutheran Good Samaritan Society (Good Samaritan Society - Prophets Riverview)
- Samantha Lauren Wallenberg, MS, OTD, OTR/L
- Winning Wheels Inc
- Winning Wheels, Inc. (STRIVE, Inc.)
- Winning Wheels, Inc.
- Winning Wheels, Inc. (Frontier Hollow)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.