Individual provider Active NPI

Kerry Rupe

  • Physical Therapist
  • La Follette, TN
National Provider Identifier
1780019794
Registry record updated Aug 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8828 Issued in TN
Practice address
2435 Jacksboro Pike
La Follette, TN 37766
Phone
(423) 566-2250
NPI assigned
Sep 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2018

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 8828 TN Primary

Addresses

Primary practice location

2435 Jacksboro Pike
La Follette, TN 37766

Mailing address

8731 Rutledge Pike
Rutledge, TN 37861-3112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131125000159 TN Practitioner - Physical Therapist in Private Practice 9234365107 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8828TNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Rehabilitation Center, Inc. Physical Therapist CurrentSince Sep 15, 2022 Accepting new patients

Locations

2435 Jacksboro Pike
Ste 2
La Follette, TN 37766
Phone (423) 566-2250

2435 Jacksboro Pike
La Follette, TN 37766
Phone (423) 566-2250

8731 Rutledge Pike
Rutledge, TN 37861
Phone (865) 828-3638

Organizations & group practices 1

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534809600000",
    "number": "1780019794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8731 RUTLEDGE PIKE",
            "city": "RUTLEDGE",
            "state": "TN",
            "postal_code": "378613112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 JACKSBORO PIKE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "37766",
            "telephone_number": "423-566-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPE",
        "first_name": "KERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2018-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "8828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Follette, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.