Tabetha L Rundle, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

23830 County Road 48
La Salle, CO 80645-8612

Phone

(970) 451-1234

NPI assigned

Dec 11, 2008

Last updated

Oct 25, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Front Range Therapists, LLC

  • Home Health Agency
  • Greeley, CO
  • NPI 1003344342
  NPD

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

{
    "created_epoch": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1164667622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 LAUREL AVE",
            "city": "EATON",
            "state": "CO",
            "postal_code": "806159062",
            "telephone_number": "970-371-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23830 COUNTY ROAD 48",
            "city": "LA SALLE",
            "state": "CO",
            "postal_code": "806458612",
            "telephone_number": "970-451-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDLE",
        "first_name": "TABETHA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTA LICENSE",
            "identifier": "PTA.0012605",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Lambert D.M.D. Professional Corporation (LaSalle Family Dentistry)
• Crystal Lopez-Villarreal
• Open and Affordable Dental at la Salle, PLLC
• Maria Pravata
• Kaley Allison Rodrigues, OTR/L
• Isabelle Amy Rusden, DDS
• Victoria Kirsten Sandelin, OTR/L
• Southeast Community Laboratory Network, LLC (Southeast Community Laboratory Network)
• Shay Stiles
• Samantha Maureen Vannest, LMT

• Physical Therapy Assistant in La Salle, CO
• Providers in La Salle, CO by specialty
• Physical Therapy Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.