Individual provider Active NPI

Stephanie Jeanne Ruccio, PT

  • Physical Therapist
  • Toccoa, GA
National Provider Identifier
1376683136
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008411 Issued in GA
Practice address
2003 Falls Rd
Toccoa, GA 30577-9700
Phone
(706) 282-4461
Fax
(706) 282-4416
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008411 GA Primary

Addresses

Primary practice location

2003 Falls Rd
Toccoa, GA 30577-9700

Mailing address

13700 Highway 197 N
Clarkesville, GA 30523-0914
Phone (706) 282-4461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220216000907 GA Practitioner - Physical Therapist in Private Practice 0143613141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

225 Adams Dr
Suite D
Demorest, GA 30535-4578
Phone (706) 754-3167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Rehabilitation and Performance Center CurrentSince Jan 24, 2022 Accepting new patients
Atlanta Rehabilitation and Performance Center CurrentSince Jan 24, 2022 Accepting new patients

Locations

225 Adams Dr
Ste D
Demorest, GA 30535
Phone (706) 754-3067

4220 Mundy Mill Pl
Ste 2B
Oakwood, GA 30566
Phone (678) 450-9933

2400 Wisteria Dr
Ste A
Snellville, GA 30078
Phone (770) 982-0102

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376683136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13700 HIGHWAY 197 N",
            "city": "CLARKESVILLE",
            "state": "GA",
            "postal_code": "305230914",
            "telephone_number": "706-282-4461",
            "fax_number": "706-282-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 FALLS RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305779700",
            "telephone_number": "706-282-4461",
            "fax_number": "706-282-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCCIO",
        "first_name": "STEPHANIE",
        "middle_name": "JEANNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.