Grant Rutledge, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3366 Issued in NE

Practice address

2805 S 88TH St
Suite 102
Omaha, NE 68124-3064

Phone

(402) 393-9390

Fax

(402) 393-9388

NPI assigned

Jul 31, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nannen Physical Therapy and Personal TrainingGroup PAC ID 9931152402, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Nannen Physical Therapy and Personal Training

  • Physical Therapist
  • Blair, NE
  • NPI 1275737322
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406764800000",
    "number": "1972911170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2805 S 88TH ST",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243064",
            "telephone_number": "402-393-9390",
            "fax_number": "402-393-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 S 88TH ST",
            "address_2": "SUITE 102",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681243064",
            "telephone_number": "402-393-9390",
            "fax_number": "402-393-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "GRANT",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NE",
            "license": "3366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZ225100000X",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470821137",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tiffany Russell
• Aniah Russellbrown
• Brenda Russo
• Jonathan P Russo, DDS
• Haley Rust
• Maci Jean Rutledge
• Jonathan Rutten
• Riki R Rutz, PA
• Dalia Nayeli Ruvalcaba Soria, LIMHP
• Jacob Roger Ruwe

• Physical Therapist in Omaha, NE
• Providers in Omaha, NE by specialty
• Physical Therapist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; 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.