In Home Pediatric Physical Therapy LLC

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

012483 Issued in OH

Legal business name

IN HOME PEDIATRIC PHYSICAL THERAPY LLC

Practice address

2468 Dysart Rd
University Heights, OH 44118-4445

Phone

(502) 510-5297

Fax

(801) 681-0724

NPI assigned

Sep 5, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rose Dues, P.T.

Title

Rose Dues, PT

Phone

(502) 510-5297

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1750782074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2468 DYSART RD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441184445",
            "telephone_number": "502-510-5297",
            "fax_number": "801-681-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2468 DYSART RD",
            "city": "UNIVERSITY HEIGHTS",
            "state": "OH",
            "postal_code": "441184445",
            "telephone_number": "502-510-5297",
            "fax_number": "801-681-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN HOME PEDIATRIC PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "DUES",
        "authorized_official_first_name": "ROSE",
        "authorized_official_title_or_position": "ROSE DUES, PT",
        "authorized_official_telephone_number": "502-510-5297",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "OH",
            "license": "012483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF OHIO DEPARTMENT OF EDUCATION PROFESSIONAL PUPIL LICENSE",
            "identifier": "OH3206763",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APTA BOARD CERTIFIED CLINICAL SPECIALIST PEDIATRICS",
            "identifier": "42253",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO PHYSICAL THERAPY LICENSE",
            "identifier": "012483",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Physical Therapist in University Heights, OH
• Providers in University Heights, OH by specialty
• Pediatric Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.