Individual provider Active NPI

Jaunita Kae Rudmann, MA, PT

  • Physical Therapist
  • Morgantown, WV
National Provider Identifier
1669219093
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
000872 Issued in WV
Practice address
205 Jade Dr
Morgantown, WV 26508-4026
Phone
(304) 216-5887
NPI assigned
Jul 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 000872 WV Primary

Addresses

Primary practice location

205 Jade Dr
Morgantown, WV 26508-4026

Mailing address

205 Jade Dr
Morgantown, WV 26508-4026
Phone (304) 216-5887

Other names 1

  • Jaunita Kae Loy Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
000872WVMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1669219093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 JADE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084026",
            "telephone_number": "304-216-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 JADE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084026",
            "telephone_number": "304-216-5887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDMANN",
        "first_name": "JAUNITA",
        "middle_name": "KAE",
        "credential": "MA, PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "000872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAUNITA",
            "last_name": "LOY",
            "middle_name": "KAE",
            "credential": "MA, PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Morgantown, WV

Sources for this page

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

Verify at the official NPI Registry.