Individual provider Active NPI

Kelsie Rozendaal

  • Physical Therapy Assistant
  • Anna, TX
National Provider Identifier
1790381689
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
2508 Noble Fir Dr
Anna, TX 75409-0500
Phone
(817) 694-5889
NPI assigned
Dec 7, 2020
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

2508 Noble Fir Dr
Anna, TX 75409-0500

Mailing address

2508 Noble Fir Dr
Anna, TX 75409-0500
Phone (817) 694-5889

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

NPI Registry JSON

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1790381689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 NOBLE FIR DR",
            "city": "ANNA",
            "state": "TX",
            "postal_code": "754090500",
            "telephone_number": "817-694-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 NOBLE FIR DR",
            "city": "ANNA",
            "state": "TX",
            "postal_code": "754090500",
            "telephone_number": "817-694-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROZENDAAL",
        "first_name": "KELSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anna, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; 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.