Active NPI
Derrick Root, DPT
- Physical Therapist
- Dillsburg, PA
National Provider Identifier
1548639362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT024232
- Practice address
- 4 Grouse Rd
Dillsburg, PA 17019-8510 - Phone
- (717) 215-8914
- NPI assigned
- Sep 22, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT024232 | PA | Primary |
Addresses
Primary practice location
4 Grouse Rd
Dillsburg, PA 17019-8510
Mailing address
4 Grouse Rd
Dillsburg, PA 17019-8510
Phone (717) 215-8914
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT024232 | Other | PA | PA STATE LICENSE TO PRACTICE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT024232 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442880000000",
"number": "1548639362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 GROUSE RD",
"city": "DILLSBURG",
"state": "PA",
"postal_code": "170198510",
"telephone_number": "717-215-8914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 GROUSE RD",
"city": "DILLSBURG",
"state": "PA",
"postal_code": "170198510",
"telephone_number": "717-215-8914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOT",
"first_name": "DERRICK",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-22",
"last_updated": "2015-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT024232",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PA STATE LICENSE TO PRACTICE",
"identifier": "PT024232",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dillsburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.