Individual provider Active NPI

Joan S Roush, MED., PT

  • Physical Therapist
  • Cherry Hill, NJ
National Provider Identifier
1740400118
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40QA00358600 Issued in NJ
Practice address
1030 Kings Hwy N
Suite 210
Cherry Hill, NJ 08034-1907
Phone
(856) 321-1900
Fax
(856) 321-1107
NPI assigned
Apr 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 40QA00358600 NJ Primary

Addresses

Primary practice location

1030 Kings Hwy N
Suite 210
Cherry Hill, NJ 08034-1907

Mailing address

130 W Apsley St
Philadelphia, PA 19144-3602
Phone (215) 848-5741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116000525 NJ Practitioner - Physical Therapist in Private Practice 0446337778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
40QA00358600NJMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independence Rehab Services PC Current Accepting new patients

Locations

1030 Kings Hwy N
Ste 210
Cherry Hill, NJ 08034
Phone (856) 321-1900

Organizations & group practices 1

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": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740400118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W APSLEY ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191443602",
            "telephone_number": "215-848-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 KINGS HWY N",
            "address_2": "SUITE 210",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341907",
            "telephone_number": "856-321-1900",
            "fax_number": "856-321-1107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSH",
        "first_name": "JOAN",
        "middle_name": "S",
        "credential": "MED., PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00358600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.