Active NPI
Gregory Eric Rosequist, PT, DPT, SCS, ATC
- Physical Therapist
- Clinton, NJ
National Provider Identifier
1174031975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA01463600
- Practice address
- 22 Walmart PLZ
Clinton, NJ 08809-1263 - Phone
- (908) 847-5210
- NPI assigned
- Jan 15, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA01463600 | NJ | Primary |
Addresses
Primary practice location
22 Walmart PLZ
Clinton, NJ 08809-1263
Mailing address
30 The Cres Apt 1
Montclair, NJ 07042-2649
Phone (973) 229-6075
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA01463600 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515974400000",
"number": "1174031975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 THE CRES APT 1",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070422649",
"telephone_number": "973-229-6075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 WALMART PLZ",
"city": "CLINTON",
"state": "NJ",
"postal_code": "088091263",
"telephone_number": "908-847-5210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSEQUIST",
"first_name": "GREGORY",
"middle_name": "ERIC",
"credential": "PT, DPT, SCS, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-15",
"last_updated": "2018-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA01463600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.