Individual provider Active NPI

Ruth M Mutinda

  • Physical Therapy Assistant
  • Overland Park, KS
National Provider Identifier
1275887986
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2100730 Issued in TX
Practice address
12425 W 120TH St
Apt 1027
Overland Park, KS 66213-4838
Phone
(913) 832-0991
NPI assigned
Nov 1, 2012
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2100730 TX Primary
Physical Therapy Assistant 225200000X NU

Addresses

Primary practice location

12425 W 120TH St
Apt 1027
Overland Park, KS 66213-4838

Mailing address

29222 Rancho Viejo Rd Ste 127
San Juan Capistrano, CA 92675-1049

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

State licenses

LicenseStateTypeSpecialty
2100730TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1275887986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29222 RANCHO VIEJO RD STE 127",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12425 W 120TH ST",
            "address_2": "APT 1027",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662134838",
            "telephone_number": "913-832-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTINDA",
        "first_name": "RUTH",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-01",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2100730",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.