Organization Active NPI

Ruby Mountain Physical Therapy

  • Physical Therapist
  • Elko, NV
National Provider Identifier
1376698514
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
RUBY MOUNTAIN PHYSICAL THERAPY
Practice address
1910 Idaho St Ste 101
Elko, NV 89801-2635
Phone
(775) 777-7722
Fax
(775) 777-7900
NPI assigned
Jan 25, 2007
Organization subpart
Yes
Parent organization
RODNEY D STEWARTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Authorized official

Name
Mrs. Monyca L Jensen
Title
Office Manager
Phone
(775) 423-5233

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

1910 Idaho St Ste 101
Elko, NV 89801-2635

Mailing address

1910 Idaho St Ste 101
Elko, NV 89801-2635
Phone (775) 777-7722

Other identifiers 1

IdentifierTypeStateIssuer
100505290MedicaidNV

National Provider Directory

National Provider Directory
Tax ID family
Ruby Mountain Physical Therapy3 organizations share this tax ID, including this one
Part of
Ruby Mountain Physical Therapy

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

875 Railroad St
Elko, NV 89801
Phone (775) 777-7722

1910 Idaho St
Ste 101
Elko, NV 89801
Phone (775) 299-2820

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679443200000",
    "number": "1376698514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 IDAHO ST STE 101",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012635",
            "telephone_number": "775-777-7722",
            "fax_number": "775-777-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 IDAHO ST STE 101",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898012635",
            "telephone_number": "775-777-7722",
            "fax_number": "775-777-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBY MOUNTAIN PHYSICAL THERAPY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RODNEY D STEWART",
        "enumeration_date": "2007-01-25",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "MONYCA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "775-423-5233",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100505290",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.