Alexandra Ruello, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015307 Issued in GA

Practice address

3333 E Cherokee Dr
Canton, GA 30115-9229

Phone

(919) 424-5080

NPI assigned

Mar 26, 2024

Last updated

Mar 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Dawsonville, GA
  • NPI 1528419751
  Medicare reassignment NPD
• Legacy Healthcare Services, Inc.

  • Physical Therapist
  • Winder, GA
  • NPI 1831619337
  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489
  NPD

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1184474439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5635 CASTLE CT",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300405279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E CHEROKEE DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159229",
            "telephone_number": "919-424-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUELLO",
        "first_name": "ALEXANDRA",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianne Marie Roth, DPT
• Venkateshwer Rao Routhu, M.D.
• Ronson M Royer, DPT, RDMS, RVT, RT N
• Natalya A Rozenberg, PHARMD
• Vilma E Ruddock, M.D.
• Jose Benjamin Ruiz-Lagos, M.D.
• Jordan S Rush, MD
• Kristen Marie Rusher
• Andrea W. Russell, D.M.D.
• Carl M. Russell, DMD, PHD

• Physical Therapist in Canton, GA
• Providers in Canton, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.