Individual provider Active NPI

Rosanne Tucker, MPT

  • Physical Therapist
  • Wheeling, WV
National Provider Identifier
1528063054
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1305 National Rd
Wheeling, WV 26003-5705
Phone
(304) 242-1390
Fax
(304) 243-5880
NPI assigned
Jun 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 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 Primary

Addresses

Primary practice location

1305 National Rd
Wheeling, WV 26003-5705

Mailing address

1305 National Rd
Wheeling, WV 26003-5705
Phone (304) 242-1390

Other identifiers 2

IdentifierTypeStateIssuer
4151732OtherWVWV MEDICARE PTAN
7305199000MedicaidWV

Other names 1

  • Rosanne Campbell Former name

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
002351WVMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Pet, LLC Past Accepting new patients
Solace Pediatric Healthcare Therapy Services Az, Inc. Physical Therapist PastSince Jan 1, 1995 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1528063054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 NATIONAL RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035705",
            "telephone_number": "304-242-1390",
            "fax_number": "304-243-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 NATIONAL RD",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260035705",
            "telephone_number": "304-242-1390",
            "fax_number": "304-243-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ROSANNE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WV MEDICARE PTAN",
            "identifier": "4151732",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7305199000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSANNE",
            "last_name": "CAMPBELL",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.