Elizabeth Ellen Rucker, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

22445 Issued in CA

Practice address

5190 Governor Dr Ste 107
San Diego, CA 92122-2848

Phone

(858) 452-0282

NPI assigned

Aug 15, 2018

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 CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

FunctionsmartGroup PAC ID 5597825380, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Functionsmart

  • Physical Therapist
  • San Diego, CA
  • NPI 1518132901
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1912487398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 GOVERNOR DR STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222848",
            "telephone_number": "858-452-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 GOVERNOR DR STE 107",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921222848",
            "telephone_number": "858-452-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "ELIZABETH",
        "middle_name": "ELLEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "22445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Marie Ruby, MD
• Charles Barnard Ruce
• Heather Mae Ruce
• Ruchira Densert, M.D. Inc
• Cierra Rucker
• Justin Allen Rucker
• Lindy D Rucks, D.D.S
• Augustin Rucobo
• Neal Curtis Rudberg, LMFT
• Adam Rudd, M.D.

• Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.