Active NPI
Cheryl E Rodnick, OTR L, CHT
- Hand Occupational Therapist
- Pocatello, ID
National Provider Identifier
1023074739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- OT-209
- Practice address
- 1950 E Clark St
STF
Pocatello, ID 83201-3314 - Phone
- (208) 232-2915
- Fax
- (208) 232-5553
- NPI assigned
- Apr 21, 2006
- 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 |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | OT-209 | ID | Primary |
Addresses
Primary practice location
1950 E Clark St
STF
Pocatello, ID 83201-3314
Mailing address
1950 E Clark St
STF
Pocatello, ID 83201-3314
Phone (208) 232-2519
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010023189 | Other | ID | REGENCE OF ID |
| W0533 | Other | ID | BLUE CROSS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT-209 | ID | MD | Hand Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1023074739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1950 E CLARK ST",
"address_2": "STF",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832013314",
"telephone_number": "208-232-2519",
"fax_number": "208-232-5553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1950 E CLARK ST",
"address_2": "STF",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832013314",
"telephone_number": "208-232-2915",
"fax_number": "208-232-5553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODNICK",
"first_name": "CHERYL",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "OTR L, CHT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-04-21",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "ID",
"license": "OT-209",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE OF ID",
"identifier": "000010023189",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "W0533",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
- Rocky Mountain Emergency Physicians, LLC
- Rocky Mountain Home Health and Hospice
- Rocky Mountain Home Health and Hospice
- Rocky Mountain Physician Group LLC
- Rocky Mountain Surgery Center
- Yolanda Rodriguez-Valdivia, MD
- Debra Lynn Rodriguez, CNS
- Ney Jimmy David Rodriguez Jr.
- Heather L. Rogers, M.S. CCC-SLP
- Trey Rogers, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.