Ruth Stephanie Waller, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PTL.0011276 Issued in CO

Practice address

311 Mapleton Ave
Boulder, CO 80304-3979

Phone

(303) 544-5700

Fax

(303) 544-5710

NPI assigned

Aug 26, 2013

Last updated

Aug 26, 2013By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ruth S Waller LLC

  • Physical Therapy Clinic/Center
  • Fort Collins, CO
  • NPI 1982470316
  NPD Authorized official

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

{
    "created_epoch": "1377475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377475200000",
    "number": "1831523984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 MAXWELL AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043972",
            "telephone_number": "303-544-5783",
            "fax_number": "303-441-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 MAPLETON AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803043979",
            "telephone_number": "303-544-5700",
            "fax_number": "303-544-5710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "RUTH",
        "middle_name": "STEPHANIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-26",
        "last_updated": "2013-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.0011276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tereasa Anne Wallace, RN, MN
• Cathrine Skogheim Walle, D.C., B.S.
• Katherine Eleanor Waller
• Lauren Alexandra Waller, LCSW
• Meredith Ann Waller, LCSW
• Leah Wallerstein, M.A.
• Sean Wallis, NP
• Lucas Bryant Walljasper
• Carol M Wallman
• Justin Brent Walmsley, LAC, MFTC

• Physical Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2013; 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.