Individual provider Active NPI

Crystal Abigail Rouli, DPT

  • Physical Therapist
  • Apple Valley, CA
National Provider Identifier
1740921675
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
301913 Issued in CA
Practice address
16049 Tuscola Rd Ste a
Apple Valley, CA 92307-0824
Phone
(760) 503-5455
NPI assigned
Apr 5, 2022
Last updated
Apr 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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 301913 CA Primary

Addresses

Primary practice location

16049 Tuscola Rd Ste a
Apple Valley, CA 92307-0824

Mailing address

16049 Tuscola Rd Ste a
Apple Valley, CA 92307-0824
Phone (760) 503-5455

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

LicenseStateTypeSpecialty
301913CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew P Danneker CurrentSince Apr 10, 2022 Accepting new patients

Locations

16049 Tuscola Rd
Ste A
Apple Valley, CA 92307
Phone (760) 503-5455

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, 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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1740921675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16049 TUSCOLA RD STE A",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923070824",
            "telephone_number": "760-503-5455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16049 TUSCOLA RD STE A",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923070824",
            "telephone_number": "760-503-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROULI",
        "first_name": "CRYSTAL",
        "middle_name": "ABIGAIL",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "301913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.