Individual provider Active NPI

Roni A Rawls, PT, DPT, OCS

  • Physical Therapist
  • Soddy Daisy, TN
National Provider Identifier
1962670851
Registry record updated Jul 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0000003715 Issued in TN
Practice address
8301B Dayton Pike
Soddy Daisy, TN 37379-4202
Phone
(423) 843-1014
Fax
(423) 843-1016
NPI assigned
Feb 14, 2008
Last updated
Jul 29, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 0000003715 TN Primary

Addresses

Primary practice location

8301B Dayton Pike
Soddy Daisy, TN 37379-4202

Mailing address

8301B Dayton Pike
Soddy Daisy, TN 37379-4202
Phone (423) 843-1014

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080401000768 TN Practitioner - Physical Therapist in Private Practice 5799862728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Life Bridges, IncGroup PAC ID 8628147410, 6 clinicians

Practice addresses (Care Compare)

764 Old Chattanooga Swpike
Cleveland, TN 37311-8566
Phone (423) 303-1959

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3715TNMDOptometrist
0000003715TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley/Cleveland Developmental Services Past Accepting new patients
Professional Therapy Services of Tennessee, LLC Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280361600000",
    "number": "1962670851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8301B DAYTON PIKE",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373794202",
            "telephone_number": "423-843-1014",
            "fax_number": "423-843-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8301B DAYTON PIKE",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373794202",
            "telephone_number": "423-843-1014",
            "fax_number": "423-843-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLS",
        "first_name": "RONI",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-14",
        "last_updated": "2010-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "0000003715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soddy Daisy, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.