Jose Antonio Rodriguez, LPTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1971-19 Issued in WI

Practice address

146 Clover St
Williams Bay, WI 53191-9779

Phone

(262) 245-6400

NPI assigned

Jan 31, 2013

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

• Antonio Rodriguez Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 31, 2013.

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1902145667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 MADISON ST",
            "city": "LAKE GENEVA",
            "state": "WI",
            "postal_code": "531471134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 CLOVER ST",
            "city": "WILLIAMS BAY",
            "state": "WI",
            "postal_code": "531919779",
            "telephone_number": "262-245-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "credential": "LPTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "1971-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTONIO",
            "last_name": "RODRIGUEZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Williams Bay, WI
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.