Active NPI
Donald Renault Rocklage, D.C.
- Chiropractor
- Philadelphia, PA
National Provider Identifier
1083806558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC009830
- Practice address
- 33 S 3Rd St
Philadelphia, PA 19106-2865 - Phone
- (215) 928-9171
- Fax
- (215) 928-9172
- NPI assigned
- Aug 17, 2007
- Last updated
- Nov 23, 2011
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC009830 | PA | Primary |
Addresses
Primary practice location
33 S 3Rd St
Philadelphia, PA 19106-2865
Mailing address
33 S 3Rd St
Philadelphia, PA 19106-2865
Phone (215) 928-9171
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 |
|---|---|---|---|
| DC009830 | PA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187308800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322006400000",
"number": "1083806558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 S 3RD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191062865",
"telephone_number": "215-928-9171",
"fax_number": "215-928-9172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 S 3RD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191062865",
"telephone_number": "215-928-9171",
"fax_number": "215-928-9172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCKLAGE",
"first_name": "DONALD",
"middle_name": "RENAULT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-17",
"last_updated": "2011-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "PA",
"license": "DC009830",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.