Active NPI
Gregory Rose, PHYSICAL THERAPIST
- Physical Therapist
- Deerfield Beach, FL
National Provider Identifier
1306054424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT 18323
- Practice address
- 1191 E Newport Center Dr
Ste PH-J
Deerfield Beach, FL 33442-7715 - Phone
- (561) 312-3334
- NPI assigned
- May 21, 2007
- 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 | PT 18323 | FL | Primary |
Addresses
Primary practice location
1191 E Newport Center Dr
Ste PH-J
Deerfield Beach, FL 33442-7715
Mailing address
305 N Sequoia Dr
West Palm BCH, FL 33409-3625
Phone (561) 312-3334
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 |
|---|---|---|---|
| PT 18323 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306054424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 N SEQUOIA DR",
"city": "WEST PALM BCH",
"state": "FL",
"postal_code": "334093625",
"telephone_number": "561-312-3334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1191 E NEWPORT CENTER DR",
"address_2": "STE PH-J",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334427715",
"telephone_number": "561-312-3334"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSE",
"first_name": "GREGORY",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 18323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Deerfield Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.