Individual provider Active NPI

Dynia Ines Rodriguez, DPT

  • Physical Therapist
  • Lawrenceville, GA
National Provider Identifier
1447828512
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
015120 Issued in GA
Practice address
455 Grayson Hwy
Lawrenceville, GA 30046-7171
Phone
(770) 962-4043
NPI assigned
Jun 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 922 PR
Physical Therapist 225100000X 015120 GA Primary

Addresses

Primary practice location

455 Grayson Hwy
Lawrenceville, GA 30046-7171

Mailing address

2670 Parkside Way
Snellville, GA 30078-3650
Phone (470) 985-6568

Other practice location 1

2576 Lawrenceville Suwanee Rd
Suwanee, GA 30024-7290
Phone (770) 962-4043

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
015120GAMDPhysical Therapist
922PRMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1447828512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 PARKSIDE WAY",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300783650",
            "telephone_number": "470-985-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 GRAYSON HWY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467171",
            "telephone_number": "770-962-4043"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2576 Lawrenceville Suwanee Rd",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300247290",
            "country_code": "US",
            "telephone_number": "770-962-4043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "DYNIA",
        "middle_name": "INES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PR",
            "license": "922",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "015120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2021; 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.