Individual provider Active NPI

Kathy D Rohaley, PT

  • Physical Therapist
  • Melbourne, FL
National Provider Identifier
1356824569
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT29789 Issued in VA
Practice address
2755 N Wickham Rd
Melbourne, FL 32935-2226
Phone
(352) 732-5590
Fax
(352) 732-0292
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT29789 VA Primary

Addresses

Primary practice location

2755 N Wickham Rd
Melbourne, FL 32935-2226

Mailing address

1541 SE 17TH St
Ocala, FL 34471-4607
Phone (352) 732-5590

Other practice location 1

325 N Williamson Blvd Ste 110
Daytona Beach, FL 32114-8172
Phone (352) 732-5590

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
PT29789VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1356824569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714607",
            "telephone_number": "352-732-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352226",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 N Williamson Blvd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Daytona Beach",
            "state": "FL",
            "postal_code": "321148172",
            "country_code": "US",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROHALEY",
        "first_name": "KATHY",
        "middle_name": "D",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "PT29789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.