Jordan M Ruedt, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14805-24 Issued in WI

Practice address

3077 N Mayfair Rd
Wauwatosa, WI 53222-4305

Phone

(414) 455-5797

Fax

(414) 257-0330

NPI assigned

Sep 9, 2019

Sex

Female

Sole proprietor

No

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 WI

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.

• Athletico LTD

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  • NPI 1821085028

  WI

  Medicare reassignment NPD
• Athletico LTD

  • Clinic/Center
  • Milwaukee, WI
  • NPI 1083940274

  Physical Therapist

  NPD
• Athletico LTD

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1508415944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224305",
            "telephone_number": "414-455-5797",
            "fax_number": "414-257-0330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUEDT",
        "first_name": "JORDAN",
        "middle_name": "M",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "14805-24",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madeline Roznos, BCBA
• Rpav Marketing LLC
• RPRD Diagnostics LLC
• Carolyn J Ruck, LCSW, CEAP
• Morrie Rudberg, RPH
• Brit Ruiz
• Elizabeth Marie Runge, MD, PHD
• Michael John Rupsch, LCSW
• Amanda Paige Russ, MS, LPC
• Kirsten Russell

• Physical Therapist in Wauwatosa, WI
• Providers in Wauwatosa, WI by specialty
• Physical Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.