Individual provider Active NPI

Roger Keith Rathbone, PT DPT

  • Physical Therapist
  • Montpelier, VA
National Provider Identifier
1467437426
Registry record updated Oct 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2305002464 Issued in VA
Practice address
16644 Mountain Rd
Montpelier, VA 23192-2600
Phone
(804) 883-3005
Fax
(804) 883-3006
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305002464 VA Primary

Addresses

Primary practice location

16644 Mountain Rd
Montpelier, VA 23192-2600

Mailing address

PO Box 369
16644 Mountain Rd
Montpelier, VA 23192-0369
Phone (804) 883-3005

Other identifiers 8

IdentifierTypeStateIssuer
426163OtherALLIANCE PPO LLC
5318282OtherAETNA
P00175805OtherPALMETTO GBA
6400902OtherUNITED HEALTHCARE
00V829K76OtherMEDICARE
102450OtherANTHEM
541669371OtherTRICARE NORTH REGION
426163OtherOPTIMUM CHOICE

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
2305002464VAMDPhysical Therapist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351123200000",
    "number": "1467437426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "address_2": "16644 MOUNTAIN RD",
            "city": "MONTPELIER",
            "state": "VA",
            "postal_code": "231920369",
            "telephone_number": "804-883-3005",
            "fax_number": "804-883-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16644 MOUNTAIN RD",
            "city": "MONTPELIER",
            "state": "VA",
            "postal_code": "231922600",
            "telephone_number": "804-883-3005",
            "fax_number": "804-883-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATHBONE",
        "first_name": "ROGER",
        "middle_name": "KEITH",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2012-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305002464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALLIANCE PPO LLC",
            "identifier": "426163",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5318282",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00175805",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6400902",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "00V829K76",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "102450",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE NORTH REGION",
            "identifier": "541669371",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "426163",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montpelier, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2012; 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.