Kervin Jay Abrero Rosas

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12284 Issued in CT

Practice address

1227 Rockbridge Rd Ste 402
Stone Mountain, GA 30087-3006

Phone

(510) 391-1463

NPI assigned

May 30, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist

  Medicare reassignment NPD
• Independent Physical Therapy, LLC

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1104878354
  Medicare reassignment NPD
• Results-Ast JV, LLC

  • Physical Therapist
  • Franklin, TN
  • NPI 1780291948
  Medicare reassignment NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1902646482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PARKWAY,",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232869",
            "telephone_number": "510-391-1463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 ROCKBRIDGE RD STE 402",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873006",
            "telephone_number": "510-391-1463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSAS",
        "first_name": "KERVIN JAY",
        "middle_name": "ABRERO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Niove Rodriguez
• Rolling Rose, Inc.
• Barbara Rollins
• Bruce Nicholas Rooney, MSW/LCSW
• Rose M Roosevelt, RN
• April A Roscoe, LPN
• Rose Petal Falls, LLC
• Mangaliso Roseman
• Raymond Rosenberg, MD
• Helen L Ross

• Physical Therapist in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.