Active NPI
Roderick John Duncan
- Physical Therapist
- Madison, WI
National Provider Identifier
1366727174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11785-24
- Practice address
- 202 S Park St
Madison, WI 53715-1507 - Phone
- (608) 417-7574
- Fax
- (608) 417-5936
- NPI assigned
- Oct 13, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11785-24 | WI | Primary |
Addresses
Primary practice location
202 S Park St
Madison, WI 53715-1507
Mailing address
600 Highland Ave
MC 2433
Madison, WI 53792-1530
Phone (608) 662-0817
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 |
|---|---|---|---|
| 11785-24 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707782400000",
"number": "1366727174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 HIGHLAND AVE",
"address_2": "MC 2433",
"city": "MADISON",
"state": "WI",
"postal_code": "537921530",
"telephone_number": "608-662-0817",
"fax_number": "608-203-4544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151507",
"telephone_number": "608-417-7574",
"fax_number": "608-417-5936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNCAN",
"first_name": "RODERICK",
"middle_name": "JOHN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-13",
"last_updated": "2024-02-13",
"certification_date": "2024-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11785-24",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.