Active NPI
Derek M Rader, DPT
- Physical Therapist
- Bethlehem, PA
National Provider Identifier
1396117271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12860
- Practice address
- 2901 Emrick Blvd
Bethlehem, PA 18020-8062 - Phone
- (610) 625-2169
- NPI assigned
- Oct 30, 2015
- Sex
- Male
- Sole proprietor
- No
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 | 12860 | WI | Primary |
Addresses
Primary practice location
2901 Emrick Blvd
Bethlehem, PA 18020-8062
Mailing address
2070 Taylor Dr
Center Valley, PA 18034-8701
Phone (414) 491-7552
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 |
|---|---|---|---|
| 12860 | WI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488844800000",
"number": "1396117271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2070 TAYLOR DR",
"city": "CENTER VALLEY",
"state": "PA",
"postal_code": "180348701",
"telephone_number": "414-491-7552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2901 EMRICK BLVD",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180208062",
"telephone_number": "610-625-2169"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADER",
"first_name": "DEREK",
"middle_name": "M",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-10-30",
"last_updated": "2017-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "12860",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.