Patricia Lynn Rutka, L.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT1190 Issued in ME

Practice address

21 Donald B. Dean Drive
S. Portland, ME 04106

Phone

(207) 874-9859

NPI assigned

Nov 12, 2009

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 12, 2009.

{
    "created_epoch": "1257984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257984000000",
    "number": "1447587464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 DONALD B. DEAN DRIVE",
            "city": "S. PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-874-9859",
            "fax_number": "207-874-9859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 DONALD B. DEAN DRIVE",
            "city": "S. PORTLAND",
            "state": "ME",
            "postal_code": "04106",
            "telephone_number": "207-874-9859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTKA",
        "first_name": "PATRICIA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "L.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-12",
        "last_updated": "2009-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ME",
            "license": "MT1190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR FEDERAL",
            "identifier": "350439700",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in S. Portland, ME
• Massage Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2009; 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.