Richard Earl De Roque, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1308 Issued in AR

Practice address

74 Cleburne Park Rd
Heber Springs, AR 72543-9106

Phone

(501) 206-0920

NPI assigned

Jul 30, 2009

Last updated

Feb 6, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Community School of Cleburne County

  • Developmentally Disabled Services Day Training Agency
  • Heber Springs, AR
  • NPI 1750596268
  NPD (past)

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

{
    "created_epoch": "1248912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265414400000",
    "number": "1982835542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 COLUMBIA DR",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720347392",
            "telephone_number": "501-472-1271",
            "fax_number": "501-513-9143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 CLEBURNE PARK RD",
            "city": "HEBER SPRINGS",
            "state": "AR",
            "postal_code": "725439106",
            "telephone_number": "501-206-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE ROQUE",
        "first_name": "RICHARD",
        "middle_name": "EARL",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-30",
        "last_updated": "2010-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT1308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125613721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louis S. Crow, DDS
• Brian J Cummings, LPC
• Dan Lister, MD PA
• Lindsay Daniel, M.S., CCC-SLP
• Justin Davis, PHARMD
• Casie Lynn Dees, PTA
• Dennis W Luter, MD
• Derrickson Wellness Counseling
• Jessica Derrickson, LPC
• April Massey Devore, LCSW

• Physical Therapist in Heber Springs, AR
• Providers in Heber Springs, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2010; 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.