Individual provider Active NPI

Meghan Roda

  • Physical Therapist
  • Flint, MI
National Provider Identifier
1184260135
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019397 Issued in MI
Practice address
1397 S Linden Rd Ste B
Flint, MI 48532-4194
Phone
(810) 230-9750
NPI assigned
Nov 25, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501019397 MI Primary

Addresses

Primary practice location

1397 S Linden Rd Ste B
Flint, MI 48532-4194

Mailing address

1397 S Linden Rd Ste B
Flint, MI 48532-4194
Phone (810) 230-9750

Other practice location 1

8273 S Saginaw St
Grand Blanc, MI 48439-2465
Phone (810) 579-7184

Other identifiers 1

IdentifierTypeStateIssuer
383499025MedicaidMI

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

LicenseStateTypeSpecialty
5501019397MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1184260135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 S LINDEN RD STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324194",
            "telephone_number": "810-230-9750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 S LINDEN RD STE B",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485324194",
            "telephone_number": "810-230-9750"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8273 S Saginaw St",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484392465",
            "country_code": "US",
            "telephone_number": "810-579-7184",
            "fax_number": "810-579-7185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODA",
        "first_name": "MEGHAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383499025",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.