Ruth Ann Fedor Burns, D.P.T.
Individual provider Active NPI Physical Therapist · Shepherdstown, WV
NPI 1740304641 · NPPES record last updated Feb 12, 2017
Key facts
- NPI
- 1740304641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 002132 (WV)
- Practice address
- 80 Maddex Dr
Shepherdstown, WV 25443-4305 - Phone
- (304) 876-9422
- Fax
- (304) 876-6869
- NPI assigned
- Mar 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
101 E State St
Attn Powerback Credentialing
Kennett Square, PA 19348-3166
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WV, VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231024000216 | WV | Practitioner - Physical Therapist in Private Practice | 9830598531 | Reassigns benefits to 1 organization |
| I20260225002077 | VA | Practitioner - Physical Therapist in Private Practice | 9830598531 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305202943 | VA | MD | Physical Therapist |
| 002132 | WV | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Powerback Rehabilitation LLC | Physical Therapist | Current |
Accepting new patients |
| Powerback Rehabilitation LLC | Physical Therapist | Current |
Accepting new patients |
| Powerback Rehabilitation LLC | Physical Therapist | Current |
Accepting new patients |
Locations
101 E State St
Kennett Square, PA 19348
Phone (610) 925-4436
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 002132 | WV | Yes |
| Physical Therapist | 225100000X | 2305202943 | VA |
Addresses
Primary practice location
80 Maddex Dr
Shepherdstown, WV 25443-4305
Mailing address
83 Veronica LN
Charles Town, WV 25414-4150
Phone (540) 539-7420
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002132 | Other | WV | WV PT LICENSE |
| N 252291218-8 | Other | HPSO LIABILITY INSURANCE | |
| 2305202943 | Other | VA | VA PT LICENSE |
Other providers in Shepherdstown, WV
- John Hudson Berkley
- Sonya Kaur Bhuller
- Sarah Ann Bleigh
- Christian Goswin Bonner
- Molly Bretone
- Joseph Harry Burton
- Canterbury Center Opco, LLC
- Canterbury of Shepherdstown, LP
- Alexandria Carthen-Franklin
- Cedar Spring Wellness PLLC
All providers in Shepherdstown, WV · Physical Therapist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.