Individual provider Active NPI

Derek Keith Rushing, DPT

  • Physical Therapist
  • Dacula, GA
National Provider Identifier
1063709699
Registry record updated Jul 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3625 Braselton Hwy Ste 204
Dacula, GA 30019-4695
Phone
(770) 271-7492
Fax
(770) 271-7426
NPI assigned
Jul 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2011

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 Primary

Addresses

Primary practice location

3625 Braselton Hwy Ste 204
Dacula, GA 30019-4695

Mailing address

3105 New College Way
Cumming, GA 30041-2892
Phone (678) 520-0474

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1309737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309737600000",
    "number": "1063709699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 NEW COLLEGE WAY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300412892",
            "telephone_number": "678-520-0474",
            "fax_number": "770-271-7426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 BRASELTON HWY STE 204",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194695",
            "telephone_number": "770-271-7492",
            "fax_number": "770-271-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSHING",
        "first_name": "DEREK",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-04",
        "last_updated": "2011-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2011; 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.