Ethan Rome, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT9384 Issued in SC

Practice address

35 Parris Island Gtwy Unit 198
Beaufort, SC 29906-4244

Phone

(843) 575-4722

Fax

(843) 459-7904

NPI assigned

Jun 28, 2017

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": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1407377658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1263 WHITE TAIL PATH",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294149105",
            "telephone_number": "504-559-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PARRIS ISLAND GTWY UNIT 198",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299064244",
            "telephone_number": "843-575-4722",
            "fax_number": "843-459-7904"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 Crill Ave Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Palatka",
            "state": "FL",
            "postal_code": "321779231",
            "country_code": "US",
            "telephone_number": "386-325-1119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROME",
        "first_name": "ETHAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-28",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT32565",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "PT9384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jackeline Rodriguez, PMHNP-BC
• Madison Rodriguez, PTA
• Jessica Roe, RBT
• Alice Rogers
• Megan Marie Rombach, PMHNP
• Joyce Romeo, RN
• Christina Lynn Rooks, FNP-C
• Denise R Rosario, LPC/LAD
• Robert Lee Roseberry
• Leslie Poston Rowell, MA, LPC, NCC

• Physical Therapist in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.

Verify at the official NPI Registry.