Individual provider Active NPI

Tracy R. Ruggles, P.T.

  • Physical Therapist
  • Dothan, AL
National Provider Identifier
1538268933
Registry record updated Oct 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH6786 Issued in AL
Practice address
512 N Shady LN
Dothan, AL 36303-2991
Phone
(334) 255-7179
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 115572 MO
Physical Therapist 225100000X 1144616 TX
Physical Therapist 225100000X PTH6786 AL Primary

Addresses

Primary practice location

512 N Shady LN
Dothan, AL 36303-2991

Mailing address

PO Box 370
Fortson, GA 31808-0370
Phone (706) 494-3071

Other names 1

  • Mrs. Tracy R Bradshaw Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191202002172 AL Practitioner - Physical Therapist in Private Practice 2062697717 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hughston Clinic PCGroup PAC ID 1355254780, 111 clinicians

Practice addresses (Care Compare)

161 E University Dr
Auburn, AL 36832-5889
Phone (334) 826-2090

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH6786ALMDPhysical Therapist
115572MOMDPhysical Therapist
1144616TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hughston Clinic, P.C. CurrentSince Oct 14, 2019 Accepting new patients
Hughston Clinic, PC CurrentSince Oct 14, 2019 Accepting new patients
Neches Rehabilitation and Testing Inc Past Accepting new patients

Locations

161 E University Dr
Auburn, AL 36832
Phone (334) 699-5747

512 N Shady Ln
Dothan, AL 36303
Phone (334) 669-5747

Interoperability endpoints

  • Direct secure messaging: tracy.ruggles.1@321.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1538268933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 370",
            "city": "FORTSON",
            "state": "GA",
            "postal_code": "318080370",
            "telephone_number": "706-494-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N SHADY LN",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363032991",
            "telephone_number": "334-255-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGGLES",
        "first_name": "TRACY",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "115572",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1144616",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH6786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACY",
            "last_name": "BRADSHAW",
            "middle_name": "R",
            "prefix": "MRS.",
            "credential": "P.T.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dothan, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.