Individual provider Active NPI

Rosamond E Dixon, PT

  • Physical Therapist
  • Albuquerque, NM
National Provider Identifier
1356568018
Registry record updated Apr 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2407 Issued in NM
Practice address
1215 Cerrillos Rd SW
Carlos Rey Es
Albuquerque, NM 87121-8016
Phone
(505) 836-7738
NPI assigned
Apr 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2008

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 2407 NM Primary

Addresses

Primary practice location

1215 Cerrillos Rd SW
Carlos Rey Es
Albuquerque, NM 87121-8016

Mailing address

1215 Cerrillos Rd SW
Carlos Rey Es
Albuquerque, NM 87121-8016
Phone (505) 836-7738

Other identifiers 1

IdentifierTypeStateIssuer
71448MedicaidNM

Other names 1

  • Ms. Rosamond E Rogers-Wilson Former name

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

LicenseStateTypeSpecialty
2407NMMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1356568018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 CERRILLOS RD SW",
            "address_2": "CARLOS REY ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871218016",
            "telephone_number": "505-836-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 CERRILLOS RD SW",
            "address_2": "CARLOS REY ES",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871218016",
            "telephone_number": "505-836-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIXON",
        "first_name": "ROSAMOND",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "2407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71448",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSAMOND",
            "last_name": "ROGERS-WILSON",
            "middle_name": "E",
            "prefix": "MS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.