{
"Npi": {
"NPI": "1467786913",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "N",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "RODRIGUEZ",
"FirstName": "ANN JANETTE",
"MiddleName": "T",
"NamePrefix": null,
"NameSuffix": null,
"Credential": "PT",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "TEODORO",
"OtherFirstName": "ANN JANETTE",
"OtherMiddleName": "REYES",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "DPT",
"OtherLastNameTypeCode": "1",
"FirstLineMailingAddress": "PO BOX 500",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKEVILLE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20833-0500",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-498-8100",
"MailingAddressFaxNumber": "301-498-0009",
"FirstLinePracticeLocationAddress": "14955 SHADY GROVE RD STE 230",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROCKVILLE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20850-8701",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-984-6594",
"PracticeLocationAddressFaxNumber": "301-984-7271",
"EnumerationDate": "09/30/2009",
"LastUpdateDate": "02/25/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "2305204012",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "PT870227",
"LicenseNumberStateCode": "DC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "225100000X",
"TaxonomyName": "Physical Therapist",
"LicenseNumber": "21351",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}