Active NPI
Ben Rickenbaugh, PT, DPT
- Physical Therapist
- Euclid, OH
National Provider Identifier
1902654213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT021096
- Practice address
- 18901 Lake Shore Blvd
Euclid, OH 44119-1078 - Phone
- (216) 531-9000
- NPI assigned
- May 10, 2024
- Sex
- Male
- Sole proprietor
- No
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 | PT021096 | OH | Primary |
Addresses
Primary practice location
18901 Lake Shore Blvd
Euclid, OH 44119-1078
Mailing address
37065 N Deerpath Dr
Lake Villa, IL 60046-6767
Phone (224) 938-0077
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 |
|---|---|---|---|
| PT021096 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715472000000",
"number": "1902654213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "37065 N DEERPATH DR",
"city": "LAKE VILLA",
"state": "IL",
"postal_code": "600466767",
"telephone_number": "224-938-0077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18901 LAKE SHORE BLVD",
"city": "EUCLID",
"state": "OH",
"postal_code": "441191078",
"telephone_number": "216-531-9000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKENBAUGH",
"first_name": "BEN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-10",
"last_updated": "2024-05-12",
"certification_date": "2024-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT021096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Euclid, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.