Teresa Rodriguez, PTA

Key facts

NPI

1376903971

Entity type

Individual (NPI type 1)

Primary specialty

Physical Therapy Assistant 225200000X

License

A-0936 (NM)

Practice address

Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649

Phone

(928) 729-8132

NPI assigned

Feb 25, 2016

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 25, 2016.

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456358400000",
    "number": "1376903971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 589",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "TERESA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2016-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NM",
            "license": "A-0936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

• Hannah Robb
• Frances A Robbins, LPN
• Vijeyakumari Roberts, C.R.N.A.
• Gilberto Rocha, RRT-NPS
• Ana Maria Rodriguez
• Miriam Christine Rollason, PA
• Cynthia Cecilia Roque, M.D.
• Michelle Rosario, RD, MHDN
• Ross N Dia
• David Lloyd Ross, PHARMD

All providers in Fort Defiance, AZ · Physical Therapy Assistant in Arizona