Michale Diane Rothgeb, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

06003715A Issued in IN

Practice address

2200 Randollia Dr
Fort Wayne, IN 46805

Phone

(260) 373-3202

Fax

(260) 373-4548

NPI assigned

Oct 31, 2014

Last updated

Oct 31, 2014By 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 names 1

• Ms. Michole Diane Ritenour Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1414713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1063817104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11109 PARKVIEW PLAZA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46845",
            "telephone_number": "260-373-3202",
            "fax_number": "260-373-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 RANDOLLIA DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46805",
            "telephone_number": "260-373-3202",
            "fax_number": "260-373-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHGEB",
        "first_name": "MICHALE",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-31",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "IN",
            "license": "06003715A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHOLE",
            "last_name": "RITENOUR",
            "middle_name": "DIANE",
            "prefix": "MS.",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Su Roth
• Theresa L Roth, RN
• Zachary D Roth, O.D.
• Holly Nicole Rothenbush, LMFT
• Amanda Rothgeb
• Rachael M Rothgeb, DPT
• Sara M Rothgeb, MSN, FNP-C
• Peter M Rothman, MD
• Rounding Providers
• Brian H Roush, LMHC

• Physical Therapy Assistant in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Physical Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.