Antoinette Derose, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305006027 Issued in VA

Practice address

2405 Fort Eustis Blvd
Yorktown, VA 23692-4163

Phone

(757) 898-3746

NPI assigned

Dec 18, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1467873380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 LEEDS",
            "city": "WILLIAMSBURG",
            "state": "VA",
            "postal_code": "231889184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 FORT EUSTIS BLVD",
            "city": "YORKTOWN",
            "state": "VA",
            "postal_code": "236924163",
            "telephone_number": "757-898-3746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEROSE",
        "first_name": "ANTOINETTE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305006027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John R Davis, R PH
• Ronnell Deanna Dawson
• Alexander Mark Dean, MS.ED
• Sheridan Dean
• Ann Marie Defiglio-Smith, MD
• Desiree Dienstag
• Michelle Melo Digman
• Bradley J Dixon, BT
• Brianne Dorr, RD
• Jadore Douglas, PHARMD

• Physical Therapist in Yorktown, VA
• Providers in Yorktown, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.