Individual provider Active NPI

Kaitlyn Nicole Rush, DPT

  • Physical Therapist
  • Cameron, NC
National Provider Identifier
1912635988
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P21416 Issued in NC
Practice address
1562 Highway 24/87
Cameron, NC 28326-9424
Phone
(910) 436-4545
Fax
(910) 497-2222
NPI assigned
Aug 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P21416 NC Primary

Addresses

Primary practice location

1562 Highway 24/87
Cameron, NC 28326-9424

Mailing address

981 High House Rd Ste 100
Cary, NC 27513-3510
Phone (919) 388-0111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220923000074 NC Practitioner - Physical Therapist in Private Practice 0840675047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Breakthrough Physical Therapy IncGroup PAC ID 9234274754, 110 clinicians

Practice addresses (Care Compare)

1562 Hwy 24/87
Cameron, NC 28326
Phone (910) 436-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P21416NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Physical Therapy Inc Physical Therapist CurrentSince Jul 12, 2022 Accepting new patients
Breakthrough Physical Therapy Physical Therapist Past Accepting new patients

Locations

981 High House Rd
#100
Cary, NC 27513
Phone (919) 388-0111

3401 Village Dr
Ste 101
Fayetteville, NC 28304
Phone (910) 483-9300

303 N 35th St
Morehead City, NC 28557
Phone (252) 247-2738

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": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660003200000",
    "number": "1912635988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 HIGH HOUSE RD STE 100",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133510",
            "telephone_number": "919-388-0111",
            "fax_number": "919-388-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1562 HIGHWAY 24/87",
            "city": "CAMERON",
            "state": "NC",
            "postal_code": "283269424",
            "telephone_number": "910-436-4545",
            "fax_number": "910-497-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSH",
        "first_name": "KAITLYN",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-09",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.