Rusti L Wilbanks, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1597 Issued in AR

Practice address

1200 S Elmira Ave
Russellville, AR 72802-9646

Phone

(479) 968-7118

Fax

(479) 968-8628

NPI assigned

Aug 12, 2008

Last updated

Apr 20, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Ms. Rusti L Mahan Former name

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

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.

• Building Blocks Pediatric Therapy, PA

  • Multi-Specialty Clinic/Center
  • Danville, AR
  • NPI 1487850749
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650412800000",
    "number": "1114173960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2109",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728112109",
            "telephone_number": "479-967-2322",
            "fax_number": "479-967-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S ELMIRA AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728029646",
            "telephone_number": "479-968-7118",
            "fax_number": "479-968-8628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBANKS",
        "first_name": "RUSTI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-12",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AR",
            "license": "PT1597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PT1597",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154573721",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUSTI",
            "last_name": "MAHAN",
            "middle_name": "L",
            "prefix": "MS.",
            "credential": "RPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sara J Whitlock, PT
• Alice Kathleen Whitlow, R.D.
• Alicia Ladawn Widner
• Lori Wiedower, P.T.
• Gary David Wilbanks, PTA
• Kerstin Wiles
• Thomas Matthew Wilkins
• Will Wilkins, RECOVERY ASSISTANT
• Erin Willcutt, M.A. LAC
• William J. Helms, MD PA

• Physical Therapist in Russellville, AR
• Providers in Russellville, AR by specialty
• Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.