Active NPI
Roger James Raleigh, MSPT
- Physical Therapist
- Coconut Creek, FL
National Provider Identifier
1205250370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT16907
- Practice address
- 3349 NW 47TH Ave
Coconut Creek, FL 33063-5904 - Phone
- (954) 557-6554
- Fax
- (954) 975-9632
- NPI assigned
- Feb 10, 2014
- 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 | PT16907 | FL | Primary |
Addresses
Primary practice location
3349 NW 47TH Ave
Coconut Creek, FL 33063-5904
Mailing address
3349 NW 47TH Ave
Coconut Creek, FL 33063-5904
Phone (954) 557-6554
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT16907 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392681600000",
"number": "1205250370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3349 NW 47TH AVE",
"city": "COCONUT CREEK",
"state": "FL",
"postal_code": "330635904",
"telephone_number": "954-557-6554",
"fax_number": "954-975-9632"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3349 NW 47TH AVE",
"city": "COCONUT CREEK",
"state": "FL",
"postal_code": "330635904",
"telephone_number": "954-557-6554",
"fax_number": "954-975-9632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RALEIGH",
"first_name": "ROGER",
"middle_name": "JAMES",
"name_prefix": "Mr.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-02-10",
"last_updated": "2014-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT16907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coconut Creek, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.