Lovely Rose Ponce Patarata, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTH10423 Issued in AL

Practice address

210 S Strawberry Ave
Demopolis, AL 36732-2154

Phone

(334) 431-4332

NPI assigned

Sep 14, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Lovely Rose Gomez Ponce Former name

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Hope LLC

  • Occupational Therapist
  • Tuscaloosa, AL
  • NPI 1497871495

  AL, Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1104596832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 S STRAWBERRY AVE",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367322154",
            "telephone_number": "334-431-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 S STRAWBERRY AVE",
            "city": "DEMOPOLIS",
            "state": "AL",
            "postal_code": "367322154",
            "telephone_number": "334-431-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATARATA",
        "first_name": "LOVELY ROSE",
        "middle_name": "PONCE",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH10423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOVELY ROSE",
            "last_name": "PONCE",
            "middle_name": "GOMEZ",
            "credential": "PHYSICAL THERAPIST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Pascal Moore Jr., CRNA
• Helen Myers, CRNP
• Erica Vivian Newburn, PHARMD
• Bianca A Norris, CRNP
• Joenel Patarata, PT
• Sheila Bouler Pfaffman, LPC
• Madison Alexis Phillips
• Taylor Phillips, OD, MBA
• Preferred Eye Care LLC
• R & O Inc

• All providers in Demopolis, AL
• Physical Therapist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.