Jennifer Lynn Rusich

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT18981 Issued in FL

Practice address

1405 Moon Harbor CT
St Augustine, FL 32092-5099

Phone

(904) 230-7204

NPI assigned

Feb 20, 2009

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

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Base Physical Therapy LLCGroup PAC ID 5799930640, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Base Physical Therapy LLC

  • Specialist
  • Tallahassee, FL
  • NPI 1841538113
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235088000000",
    "number": "1285874917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 MOON HARBOR CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320925099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 MOON HARBOR CT",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320925099",
            "telephone_number": "904-230-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSICH",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Rudert, PT, DPT
• Jearlean Ruiz Marin, PSY.D.
• Rural Health Care Inc.
• Rural Health Care, Incorporated
• Rural Health Care, Incorporated
• Ivory Russ
• Russell Denea, MD, LLC
• Caitlin Owen Russell
• Helena Russell, APRN
• Valerie A Russell, LCSW

• Physical Therapist in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.