Amy Rust, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3161 Issued in SC

Practice address

872 Shaw Rd
Woodruff, SC 29388-9576

Phone

(443) 786-1019

NPI assigned

Aug 7, 2014

Last updated

Aug 7, 2014By the provider in NPPES

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

Other names 1

• Amy Deibel Former name

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.

{
    "created_epoch": "1407369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1447669007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "872 SHAW RD",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293889576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "872 SHAW RD",
            "city": "WOODRUFF",
            "state": "SC",
            "postal_code": "293889576",
            "telephone_number": "443-786-1019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUST",
        "first_name": "AMY",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "3161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "DEIBEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Regenesis Organization Community Health Center (Regenesis Health Care Pharmacy #5)
• Regenesis Organization Community Health Center (Woodruff Medical Center)
• Jennifer Reynaga Aceves, BCBA
• Janet Nicole Rhinehart Vaughan
• Rpvrw Healthcare,LLC (Fleetwood Pharmacy Of Woodruff)
• Diane J Schlafly, L.M.T.
• Gajanan Ramnath Shanbhag, MD
• Pramila Gajanan Shanbhag, MD
• Laura Shields
• Toshiva Deshane Shippy, FNP

• Physical Therapy Assistant in Woodruff, SC
• Providers in Woodruff, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2014; 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.