Michael J. Rourke, M.S.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11729 Issued in MA

Practice address

110 Liberty St
Suite 1300
Brockton, MA 02301-5521

Phone

(508) 580-0144

Fax

(508) 580-0449

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fitness Forum Services LLC

  • Physical Therapist
  • Brockton, MA
  • NPI 1205803558
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1124096052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 E CENTER ST",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "023791824",
            "telephone_number": "508-559-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "address_2": "SUITE 1300",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015521",
            "telephone_number": "508-580-0144",
            "fax_number": "508-580-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROURKE",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "M.S.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "11729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "417280",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "1017758",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "Y67392",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOSTON MEDICAL CENTER HEALTHNET",
            "identifier": "00000003237",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0316547",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Menachem D Roth, D.M.D.MMSC.
• Margaret Jean Rothemich, LPN
• Ernest Kenneth Rotman, PA-C,MPAS
• Elizabeth Thomas Rotrosen
• Daniel Brett Rounsaville, PH.D.
• Berline Rousseau
• Robert A Rowe, PT
• Kingyoung Rowland
• Janet Anne Roxborough, FNP
• Sumon Roy, MD

• Physical Therapist in Brockton, MA
• Providers in Brockton, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.