Breanna Roderos, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP007937T Issued in GA

Practice address

119 Canal St Ste 104
Pooler, GA 31322-4094

Phone

(912) 330-8444

NPI assigned

Sep 7, 2021

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

Medicare fee-for-service enrollment

Enrolled in GA, NC, TN3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Elite Sports Medicine and Orthopaedic Center PLCGroup PAC ID 8729009634, 90 clinicians

Results-Ast JV LLCGroup PAC ID 4486066396, 390 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Results-Ast JV, LLC

  • Physical Therapist
  • Franklin, TN
  • NPI 1780291948
  Medicare reassignment Care Compare group NPD
• Elite Sports Medicine and Orthopaedic Center, PLC

  • Specialist
  • Nashville, TN
  • NPI 1528281623
  Medicare reassignment Care Compare group
• Benchmark Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Duluth, GA
  • NPI 1083666903
  Medicare reassignment NPD
• Drayer Physical Therapy Georgia LLC

  • Physical Therapist
  • Loganville, GA
  • NPI 1962830406
  Medicare reassignment NPD
• Independent Physical Therapy of Georgia, LLC

  • Physical Therapist
  • Fort Oglethorpe, GA
  • NPI 1780636068
  Medicare reassignment NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist

  Medicare reassignment NPD
• Benchmark Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1356894604

  NC

  Medicare reassignment NPD
• Independent Physical Therapy, LLC

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1104878354
  Medicare reassignment NPD
• Benchmark Physical Therapy Inc

  • Physical Therapist
  • Riverdale, GA
  • NPI 1427000777
  NPD
• Independent Physical Therapy of Georgia, LLC

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1306013941

  Physical Therapist

  NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hermitage, TN
  • NPI 1104068063
  NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD

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

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1144998972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CANAL ST STE 104",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224094",
            "telephone_number": "912-330-8444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11172 Highway 142 N",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300142547",
            "country_code": "US",
            "telephone_number": "678-712-3692",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7938 Ga Highway 21 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Port Wentworth",
            "state": "GA",
            "postal_code": "314079808",
            "country_code": "US",
            "telephone_number": "912-965-0601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "461 Johnny Mercer Blvd Ste C2",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314102221",
            "country_code": "US",
            "telephone_number": "912-231-3619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5710 Ogeechee Rd Ste 440",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314059515",
            "country_code": "US",
            "telephone_number": "912-777-3378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 E Victory Dr Ste 4A",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314044195",
            "country_code": "US",
            "telephone_number": "912-236-7020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7805 Abercorn St Ste 21",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314062457",
            "country_code": "US",
            "telephone_number": "912-356-3559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODEROS",
        "first_name": "BREANNA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "CP007937T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenay Latrice Roberts
• Alauna Robinson
• Sharon Robinson
• Melissa Robitaille, DPM
• Kathryn Ann Rockhill
• Kerry Roe, PHARMD
• Zachary Romig
• Alyssa Romigh
• Felicia Rose, RBT
• Rondesha Rebecca Rose, RBT

• Physical Therapist in Pooler, GA
• Providers in Pooler, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.