Kristine L Roush, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501008956 Issued in MI

Practice address

1650 Barlow Street
Suite 11
Traverse City, MI 49684

Phone

(231) 941-3100

Fax

(231) 922-0382

NPI assigned

Feb 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508901646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 BARLOW STREET",
            "address_2": "SUITE 11",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-941-3100",
            "fax_number": "231-922-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 BARLOW STREET",
            "address_2": "SUITE 11",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49684",
            "telephone_number": "231-941-3100",
            "fax_number": "231-922-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "KRISTINE",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501008956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "650B810890",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00097059",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4597265",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Stover Rosso, PT
• Jennifer L Rostamabadi-Cook, D.O.
• Katherine A Roth, MD
• Sara L Roth, MD
• Jill Rountree, LMSW
• Rebecca Sallee Roush, P.T.
• Nathan Rousse, C.N.P.
• Donald Edward Routzahn, RPH
• Emily Elise Ruby, LPC
• Joshua Michael Ruch, M.D.

• Physical Therapist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.