Phillip Rustin, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014149 Issued in GA

Practice address

2319 Prince Ave
Athens, GA 30606-6030

Phone

(706) 425-8888

NPI assigned

Aug 5, 2019

Last updated

Aug 5, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1780239905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 GREYSTONE COMMERCIAL BLVD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422660",
            "telephone_number": "205-745-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2319 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066030",
            "telephone_number": "706-425-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTIN",
        "first_name": "PHILLIP",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "PT014149",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Lynn Russell, PA-C
• Jessica Russell
• Kristen Leigh Russell, PHARMD
• Garth Russo, MD
• Natalie Russo, MD
• Christopher Ryan
• David Steven Ryan, MD
• Bryan Scott Ryles, PH.D.
• Lauren Smith Ryther, PT, DPT, ATC
• S and S Home Care LLC

• Physical Therapist in Athens, GA
• Providers in Athens, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2019; 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.