Robert Roche, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502004361 Issued in MI

Practice address

1411 3Rd St Ste C
Port Huron, MI 48060-5480

Phone

(800) 451-0481

NPI assigned

Jan 8, 2019

Sex

Male

Sole proprietor

No

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": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1558834010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 ELMWOOD ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480602752",
            "telephone_number": "810-841-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 3RD ST STE C",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480605480",
            "telephone_number": "800-451-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502004361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fredric Burton Roberts, ED D
• Jeremy Michael Roberts, D.O.
• Quinn Olivia Roberts
• Riley Robinson, PA-C
• Thomas James Robinson
• Raulie D Rodrigo, MD
• Maritza Rodriguez-Arseneau, LPC
• Roe Services Incorporated
• Donna Lynn Roe, OTR
• Justin Rohde

• Physical Therapy Assistant in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.