Simon Rodriguezlopez, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

25MT00244500 Issued in NJ

Practice address

1 Jets Dr
Florham Park, NJ 07932-1215

Phone

(973) 549-4706

NPI assigned

Sep 19, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1346769551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 MAITLAND AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075022034",
            "telephone_number": "973-405-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JETS DR",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079321215",
            "telephone_number": "973-549-4706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZLOPEZ",
        "first_name": "SIMON",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NJ",
            "license": "25MT00244500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ATHLETIC TRAINER",
            "identifier": "25T00244500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Roger Diruggiero (Morris Omni Med)
• Carla Rogers
• Gary Romaka, D.O.
• Elizabeth Romano, PT, DPT
• Rooted in Resilience LLC

• Athletic Trainer in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; 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.