Individual provider Active NPI

Cheryl Rodak

  • Physical Therapist
  • Kirkwood, MO
National Provider Identifier
1750720678
Registry record updated Jun 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
106820 Issued in MO
Practice address
1001 S Kirkwood Rd Ste 150
Kirkwood, MO 63122-7251
Phone
(314) 821-7554
NPI assigned
Jun 25, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2013

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 106820 MO Primary

Addresses

Primary practice location

1001 S Kirkwood Rd Ste 150
Kirkwood, MO 63122-7251

Mailing address

2727 China Lake Dr
Saint Louis, MO 63129-5449

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
106820MOMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372118400000",
    "number": "1750720678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 CHINA LAKE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631295449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 S KIRKWOOD RD STE 150",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631227251",
            "telephone_number": "314-821-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODAK",
        "first_name": "CHERYL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "106820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2013; 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.