Individual provider Active NPI

Angela Freeman Rutty, O.T.

  • Occupational Therapist
  • Harrisburg, PA
National Provider Identifier
1093909368
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT009414 Issued in OH
Practice address
5690 Allentown Blvd
Harrisburg, PA 17112-4046
Phone
(717) 216-8699
NPI assigned
Aug 30, 2007
Last updated
Dec 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT009414 OH Primary
Specialist 174400000X 2007026382 MO

Addresses

Primary practice location

5690 Allentown Blvd
Harrisburg, PA 17112-4046

Mailing address

5690 Allentown Blvd
Harrisburg, PA 17112-4046
Phone (717) 216-8699

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT009414OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Rehabilitation and Health Services, Inc. CurrentSince Jan 2, 2022 Accepting new patients
Phoenix Rehabilitation and Health Services, Inc. PastSince Jan 2, 2022 Accepting new patients

Locations

5690 Allentown Blvd
Harrisburg, PA 17112
Phone (717) 216-8699

Organizations & group practices 2

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": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1093909368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5690 ALLENTOWN BLVD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171124046",
            "telephone_number": "717-216-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5690 ALLENTOWN BLVD",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171124046",
            "telephone_number": "717-216-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTTY",
        "first_name": "ANGELA",
        "middle_name": "FREEMAN",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT009414",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MO",
            "license": "2007026382",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; 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.