Rusty M Wood, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1460 Issued in ID

Practice address

704 McKinley Avenue
Kellogg, ID 83837

Phone

(208) 783-3015

NPI assigned

Mar 24, 2011

Sex

Male

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 ID

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shellman Inc PAGroup PAC ID 4981592938, 45 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Shellman Inc PA

  • Physical Therapist
  • Coeur D Alene, ID
  • NPI 1326050253
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1295034684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 546",
            "city": "PINEHURST",
            "state": "ID",
            "postal_code": "83850",
            "telephone_number": "208-682-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 MCKINLEY AVENUE",
            "city": "KELLOGG",
            "state": "ID",
            "postal_code": "83837",
            "telephone_number": "208-783-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "RUSTY",
        "middle_name": "M",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "1460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farah Esther Vega, MD
• Adrianne Inez Vest, PTA
• Casey Malia Vincent, LCSW
• Garret N Wendt, PHARMD
• Richard Lee Wilgus
• Valerie Wood, OTR/L
• Tony Wright
• Linda Josefine Yawn, FNP-C
• Yokes Food Inc
• Loren Ken Zeitz, CRNA

• Physical Therapist in Kellogg, ID
• Providers in Kellogg, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.