Individual provider Active NPI

Rebecca Sara Rucker, DPT, OCS, CSCS

  • Orthopedic Physical Therapist
  • Puyallup, WA
National Provider Identifier
1922131440
Registry record updated Mar 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT00008904 Issued in WA
Practice address
7719 64TH Ave E
Puyallup, WA 98371-5515
Phone
(253) 200-0741
NPI assigned
Mar 13, 2007
Last updated
Mar 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT00008904 WA Primary

Addresses

Primary practice location

7719 64TH Ave E
Puyallup, WA 98371-5515

Mailing address

7719 64TH Ave E
Puyallup, WA 98371-5515
Phone (253) 200-0741

Other identifiers 2

IdentifierTypeStateIssuer
7121973MedicaidWA
0193067OtherWAL&I

Other names 1

  • Rebecca Thorndill Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT00008904WAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physio Movement & Performance, PLLC CurrentSince Mar 9, 2020 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy, Inc. Past Accepting new patients
Sheila K Settle PT PLLC Orthopedic PastSince Oct 25, 2004 Accepting new patients
Northwest Center for Sports Medicine & Physical Therapy Inc Orthopedic PastSince Dec 8, 2005 Accepting new patients

Locations

615 S Baker St
Tacoma, WA 98402
Phone (253) 200-0741

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583107200000",
    "number": "1922131440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7719 64TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983715515",
            "telephone_number": "253-200-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7719 64TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983715515",
            "telephone_number": "253-200-0741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "REBECCA",
        "middle_name": "SARA",
        "name_prefix": "Ms.",
        "credential": "DPT,  OCS, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-03-02",
        "certification_date": "2020-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "WA",
            "license": "PT00008904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7121973",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0193067",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "THORNDILL",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; 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.