Individual provider Active NPI

Thomas Rodeghero, DPT

  • Physical Therapist
  • Hannibal, MO
National Provider Identifier
1205986239
Registry record updated Feb 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2006034980 Issued in MO
Practice address
3522 Palmyra Rd
Suite a
Hannibal, MO 63401-2212
Phone
(573) 248-8076
Fax
(573) 248-8082
NPI assigned
Jan 11, 2007
Last updated
Feb 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2014

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 2006034980 MO Primary

Addresses

Primary practice location

3522 Palmyra Rd
Suite a
Hannibal, MO 63401-2212

Mailing address

10960 Scotts Place
Hannibal, MO 63401
Phone (573) 248-8076

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

Practice roles

OrganizationSpecialtyStatusNew patients
Access Physical Therapy Physical Therapist CurrentSince Feb 19, 2013 Accepting new patients
K.B. Therapy, Inc. Physical Therapist PastSince Jan 1, 2002 Accepting new patients

Locations

3522 Palmyra Rd
#A
Hannibal, MO 63401
Phone (573) 248-8076

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1205986239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10960 SCOTTS PLACE",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "63401",
            "telephone_number": "573-248-8076",
            "fax_number": "573-248-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3522 PALMYRA RD",
            "address_2": "SUITE A",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634012212",
            "telephone_number": "573-248-8076",
            "fax_number": "573-248-8082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEGHERO",
        "first_name": "THOMAS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2006034980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.

Verify at the official NPI Registry.