Sidney Avan Rudd, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

009233 Issued in KY

Practice address

315 W 5TH St Ste 200
Benton, KY 42025-1152

Phone

(270) 252-7200

Fax

(270) 252-7201

NPI assigned

Nov 6, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dawson Physical Therapy, PLLCGroup PAC ID 6204199540, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dawson Physical Therapy, PLLC

  • Physical Therapy Clinic/Center
  • Benton, KY
  • NPI 1760910939

  Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1801619929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 OAK LEVEL RD",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420255354",
            "telephone_number": "270-205-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 W 5TH ST STE 200",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420251152",
            "telephone_number": "270-252-7200",
            "fax_number": "270-252-7201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "SIDNEY",
        "middle_name": "AVAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "009233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rma - Operating, Inc.
• Rma-Operating, Inc.
• Jan C Roberson, LPCC
• Jeana Lee Rodgers, DC
• Paul Rudd, REG DIETICIAN
• Claude E Saint-Jacques, MD
• Kayle Sanders, RN, SANE
• Samantha Ann Scholl, MSN, APRN, FNP-C
• Jerry Cendell Sells, D.M.D
• Brady Shollenbarger

• Physical Therapist in Benton, KY
• Providers in Benton, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.