John Jospeh Rodriguez, P.T.A.

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A1383 Issued in MD

Practice address

3640 Corls Ridge Rd
Fayetteville, PA 17222-9615

Phone

(717) 749-5460

NPI assigned

Oct 25, 2010

Last updated

Oct 25, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1287964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287964800000",
    "number": "1396045381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78",
            "city": "SOUTH MOUNTAIN",
            "state": "PA",
            "postal_code": "172610078",
            "telephone_number": "717-749-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 CORLS RIDGE RD",
            "city": "FAYETTEVILLE",
            "state": "PA",
            "postal_code": "172229615",
            "telephone_number": "717-749-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOHN",
        "middle_name": "JOSPEH",
        "name_prefix": "Mr.",
        "credential": "P.T.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-25",
        "last_updated": "2010-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A1383",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "PA",
            "license": "TE1000405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paramount Nursing and Rehabilitation at Fayetteville, LLC
• Passage Village of Laurel Run Operations, LLC (Laurel Care Nursing & Rehabilitation Center)
• Piney Partners LP (The Village of Laurel Run)
• Matthew Pollard, NCC, LPC
• Rite Aid of Pennsylvania LLC (Rite Aid Pharmacy 00232)
• Adam Patrick Rowland, M.S. CCC-SLP
• Meredith Jean Schellhase, PA-C
• Monica Scoville Tudorache, MA
• Alivia Margarett Shank
• Enoch Graham Shissler, MD

• Physical Therapy Assistant in Fayetteville, PA
• Providers in Fayetteville, PA by specialty
• Physical Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.