Active NPI
Allison Ruddle
- Physical Therapist
- Pinedale, WY
National Provider Identifier
1508699836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTA-1150
- Practice address
- 1100 W Wilson St # 8
Pinedale, WY 82941-5400 - Phone
- (307) 367-3452
- NPI assigned
- Aug 22, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTA-1150 | WY | Primary |
Addresses
Primary practice location
1100 W Wilson St # 8
Pinedale, WY 82941-5400
Mailing address
4671 Buffalo Hills Rd
Franklin, WV 26807-5566
Phone (304) 668-4543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-1150 | WY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724284800000",
"number": "1508699836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4671 BUFFALO HILLS RD",
"city": "FRANKLIN",
"state": "WV",
"postal_code": "268075566",
"telephone_number": "304-668-4543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 W WILSON ST # 8",
"city": "PINEDALE",
"state": "WY",
"postal_code": "829415400",
"telephone_number": "307-367-3452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDDLE",
"first_name": "ALLISON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-22",
"last_updated": "2024-08-22",
"certification_date": "2024-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "PTA-1150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pinedale, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.