Active NPI
Rommel Patrick Brown Cadorna, RPT
- Geriatric Physical Therapist
- Wayne, MI
National Provider Identifier
1336705516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Physical Therapist
- License
- 5501015130
- Practice address
- 3999 Venoy Rd
Wayne, MI 48184-1485 - Phone
- (734) 727-0440
- NPI assigned
- May 14, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Geriatric Physical Therapist | 2251G0304X | 5501015130 | MI | Primary |
Addresses
Primary practice location
3999 Venoy Rd
Wayne, MI 48184-1485
Mailing address
49872 Alden
Canton, MI 48188-2869
Phone (734) 219-8740
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5501015130 | Other | LARA , STATE OF MICHIGAN |
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 |
|---|---|---|---|
| 5501015130 | MI | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Better Care Therapy Services LLC | Geriatrics | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557792000000",
"number": "1336705516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49872 ALDEN",
"city": "CANTON",
"state": "MI",
"postal_code": "481882869",
"telephone_number": "734-219-8740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3999 VENOY RD",
"city": "WAYNE",
"state": "MI",
"postal_code": "481841485",
"telephone_number": "734-727-0440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CADORNA",
"first_name": "ROMMEL PATRICK",
"middle_name": "BROWN",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-14",
"last_updated": "2019-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "2251G0304X",
"taxonomy_group": "",
"desc": "Physical Therapist, Geriatrics",
"state": "MI",
"license": "5501015130",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LARA , STATE OF MICHIGAN",
"identifier": "5501015130",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wayne, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.