Individual provider Active NPI

David Korogoda

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1619528122
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
7540 N 19TH Ave Ste 200
Phoenix, AZ 85021-7967
Phone
(888) 873-4221
NPI assigned
Sep 25, 2019
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

7540 N 19TH Ave Ste 200
Phoenix, AZ 85021-7967

Mailing address

7540 N 19TH Ave Ste 200
Phoenix, AZ 85021-7967

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Outpatient Rehabilitation Services, LLC CurrentSince Oct 30, 2023 Accepting new patients
Paragon Outpatient Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 30, 2023 Accepting new patients

Locations

2605 Swallow Rd
Rm 201
Reidsville, NC 27320
Phone (704) 251-2602

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1619528122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 N 19TH AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 N 19TH AVE STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850217967",
            "telephone_number": "888-873-4221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROGODA",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-25",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.