Active NPI
Taylor Scott Runsick, PTA
- Physical Therapist
- Wynne, AR
National Provider Identifier
1891179990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5409
- Practice address
- 661 Highway 64B
Wynne, AR 72396-8506 - Phone
- (870) 208-7877
- NPI assigned
- Jul 17, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3987 | AR | |
| Physical Therapist | 225100000X | 5409 | AR | Primary |
Addresses
Primary practice location
661 Highway 64B
Wynne, AR 72396-8506
Mailing address
302 Evelyn Ave E
Wynne, AR 72396-3606
Phone (870) 208-7877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 211-505-721 | Medicaid | AR |
Other names 1
- Taylor Lyndsey Scott
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5409 | AR | MD | Physical Therapist |
| 3987 | AR | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crowley'S Ridge Therapies, Inc | Physical Therapist | Past | Accepting new patients |
| Leap Therapy Solutions, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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": "1437091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699228800000",
"number": "1891179990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "302 EVELYN AVE E",
"city": "WYNNE",
"state": "AR",
"postal_code": "723963606",
"telephone_number": "870-208-7877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "661 HIGHWAY 64B",
"city": "WYNNE",
"state": "AR",
"postal_code": "723968506",
"telephone_number": "870-208-7877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNSICK",
"first_name": "TAYLOR",
"middle_name": "SCOTT",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-17",
"last_updated": "2023-11-06",
"certification_date": "2023-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AR",
"license": "3987",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AR",
"license": "5409",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "211-505-721",
"state": "AR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "TAYLOR",
"last_name": "SCOTT",
"middle_name": "LYNDSEY",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Wynne, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.