Rosa Isabel Garnica-Gentry, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05004414A Issued in IN

Practice address

RR No. 2 Box 208
Linton, IN 47441

Phone

(812) 847-9675

Fax

(812) 847-4708

NPI assigned

Oct 22, 2007

Last updated

Oct 22, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rosa Isabel Garnica Burgos Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1790974228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR NO. 2 BOX 208",
            "city": "LINTON",
            "state": "IN",
            "postal_code": "47441",
            "telephone_number": "812-847-9675",
            "fax_number": "812-847-4708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RR NO. 2 BOX 208",
            "city": "LINTON",
            "state": "IN",
            "postal_code": "47441",
            "telephone_number": "812-847-9675",
            "fax_number": "812-847-4708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNICA-GENTRY",
        "first_name": "ROSA",
        "middle_name": "ISABEL",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05004414A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000194858",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSA",
            "last_name": "GARNICA BURGOS",
            "middle_name": "ISABEL",
            "credential": "PHYSICAL THERAPIST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Linton, IN
• Providers in Linton, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.