Corissa Michele Rossow, PT, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1155409 Issued in TX

Practice address

1318 Memorial Dr
Bryan, TX 77802-5215

Phone

(979) 776-2872

Fax

(979) 776-1456

NPI assigned

Oct 26, 2006

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 names 1

• Miss Corissa Michele Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254355200000",
    "number": "1861577199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 PASSENDALE LN",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778454060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1318 MEMORIAL DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025215",
            "telephone_number": "979-776-2872",
            "fax_number": "979-776-1456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSSOW",
        "first_name": "CORISSA",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "PT, MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2009-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1155409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORISSA",
            "last_name": "SMITH",
            "middle_name": "MICHELE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mark Richard Rose, MD
• Jennifer Roselius, LPC
• Amanda N Ross, LMFT-A
• Ania Deshanae Ross
• Julia Ross
• Kathryn Ruth Rothermel, M.S., CCC-SLP
• Alina J. Rouk, M.D.
• Donald Wayne Roundtree Jr., PT, DPT
• Loyd Douglas Rowe Jr., RPH
• Grant Marshall Rowland, M.D.

• Physical Therapist in Bryan, TX
• Providers in Bryan, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2009; 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.