Sara Ruckenbrod, DPT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

3719 Issued in AR

Practice address

3801 Main Dr Ste B
Fayetteville, AR 72704-6364

Phone

(479) 856-6400

Fax

(479) 856-6623

NPI assigned

Aug 19, 2013

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 AR

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 and National Provider Directory roles.

• All About Therapy, LLC

  • Clinic/Center
  • Prairie Grove, AR
  • NPI 1548807944
  Medicare reassignment NPD Authorized official
• Horse-Play Outdoor Center, Inc

  • Pediatrics Physician
  • Prairie Grove, AR
  • NPI 1982161402
  NPD Authorized official
• Adair Ya, LLC

  • Speech-Language Pathologist
  • Van Buren, AR
  • NPI 1962885590
  NPD (past)
• Thera-Play Pediatric Services

  • Speech-Language Pathologist
  • Fayetteville, AR
  • NPI 1104165307
  NPD (past)

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1356774970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 MAIN DR STE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046364",
            "telephone_number": "479-856-6400",
            "fax_number": "479-856-6623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 MAIN DR STE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727046364",
            "telephone_number": "479-856-6400",
            "fax_number": "479-856-6623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKENBROD",
        "first_name": "SARA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AR",
            "license": "3719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Natalie C Rowe, DPT
• Debbie Royal, OTR L
• Phillip Rozell, PD
• Gregory Shayne Rozier, DMD
• Rpi Sleep and Mobility, LLC
• Holly Herring Ruddell
• Lori Beth Ruddick, LCSW
• Abby Rose Rudolph, APRN
• Madeline Rudolph
• Jeffrey Ruff, PHARMD

• Pediatric Physical Therapist in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Pediatric Physical Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.