Active NPI
Herbert Randall Rodriguez, PT, DPT, MPH
- Orthopedic Physical Therapist
- Gresham, OR
National Provider Identifier
1568940567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 60044
- Practice address
- 270 NW Burnside Rd
Gresham, OR 97030-3836 - Phone
- (503) 215-9146
- NPI assigned
- Aug 1, 2018
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 60044 | OR | Primary |
Addresses
Primary practice location
270 NW Burnside Rd
Gresham, OR 97030-3836
Mailing address
270 NW Burnside Rd
Gresham, OR 97030-3836
Phone (503) 215-9146
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 |
|---|---|---|---|
| 60044 | OR | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1533081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533081600000",
"number": "1568940567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "270 NW BURNSIDE RD",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303836",
"telephone_number": "503-215-9146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 NW BURNSIDE RD",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303836",
"telephone_number": "503-215-9146"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "HERBERT",
"middle_name": "RANDALL",
"credential": "PT, DPT, MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-08-01",
"last_updated": "2018-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "OR",
"license": "60044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.