MR. H. RUFFIN WALDEN III (NPI# 1972703809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972703809 |
| Entity Type | Individual |
| Full Name | MR. H. RUFFIN WALDEN III |
| Credential | PT |
| Practice Address |
1301 S Koke Mill Rd Springfield IL 62711-9252 |
| Mailing Address |
Po Box 9469 Springfield IL 62791-9469 |
| Practice Telephone | 2175479100 |
| Practice Fax Number | 2175479247 |
| Mailing Telephone | 2175479100 |
| Mailing Fax Number | 2175479247 |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2009-12-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
070-001474 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE ID # | 916500 | 01 |
| IL | RAILROAD MEDICARE | P00769841 | 01 |
| Street Address |
1301 S KOKE MILL RD |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62711-9252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902892607 | D Gordon Allan | Orthopaedic Surgery | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2005-09-27 |
| 1558973461 | Charity E Williams | Physical Therapist | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-08-21 |
| 1811509821 | Christina Prefountain | Registered Nurse | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-08-20 |
| 1467061408 | Daniel S Rebeck | Physical Therapist | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-07-27 |
| 1245850767 | Zachary M Barnett | Physician Assistant | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-04-24 |
| 1356961908 | Jessica Brough | Physician Assistant | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-04-23 |
| 1013536093 | Molly L Morgan | Physical Therapist | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-04-10 |
| 1326670183 | Jeffery R Chambers | Nurse Practitioner | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-02-10 |
| 1225677396 | Carrie F Thornton | Registered Nurse | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2020-01-06 |
| 1730724972 | Lindsay Breanne Dixon | Nurse Practitioner | 1301 S Koke Mill Rd, Springfield, IL 62711-9252 | 2019-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578057220 | Merissa Pryor | Social Worker | 4200 Conestoga Drive, Mbn 120, Springfield, IL 62711 | 2018-06-17 |
| 1255884623 | Dental Professionals of Illinois, P.C. | Dentist | 2740 Prairie Crossing Drive, Springfield, IL 62711 | 2016-08-02 |
| 1841682424 | Americare At Centennial Pointe Assisted Living LLC | Assisted Living Facility | 3440 Hedley Road, Springfield, IL 62711 | 2015-02-19 |
| 1306249248 | Schon Dental, LLC | Dentist | 2809 Mansion Road Suite D, Springfield, IL 62711 | 2014-10-07 |
| 1891105490 | John Weiss | Pharmacist | 4200 Conestoga Drive, Springfield, IL 62711 | 2014-05-05 |
| 1720350689 | Victor Harold Lary | Family Medicine | 3251 Spaulding Orchard Road, Springfield, IL 62711 | 2012-02-07 |
| 1902181795 | Amanda Rose Davis | Pharmacist | 2500 Koke Mill Rd, Springfield, IL 62711 | 2011-10-12 |
| 1316233703 | Karen Zerkle | Dentist | 2809 Mansion Rd, Suite D, Springfield, IL 62711 | 2011-06-23 |
| 1255520557 | Link Chiropractic LLC | Chiropractor | 7012 Kingsmill Ct, Springfield, IL 62711 | 2007-10-23 |
| 1669688230 | Victoria Lynn Driskill | Dentist | 4701 W. Wabash Ave, Springfield, IL 62711 | 2007-05-14 |
| Find all providers in zip 62711 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124656574 | Richard Dean Maas | Physical Therapist | 2230 W Sunset St, Springfield, MO 65807-5980 | 2020-03-31 |
| 1235773771 | Anne Wuhrer | Physical Therapist | 8001 Braddock Rd Ste 100, Springfield, VA 22151-2110 | 2019-10-28 |
| 1043546401 | Zbigniew Paluch | Physical Therapist | 336 Longhill St, Springfield, MA 01108-1407 | 2009-10-20 |
| 1689821910 | Michael Lee Hillstrand | Physical Therapist | 650 Harlow Rd, #203, Springfield, OR 97477-1233 | 2008-08-18 |
| 1518970870 | R. Dennis Mathewson | Physical Therapist | 360 Birnie Ave, Springfield, MA 01199-0001 | 2006-08-15 |
| 1760092290 | Kristina Wendl | Physical Therapist | 300 Birnie Ave, Springfield, MA 01107-1107 | 2020-08-10 |
| 1396367264 | Brandon Allen Lane | Physical Therapist | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2020-05-13 |
| 1265053276 | Robert Brent Doss | Physical Therapist | 3545 S National Ave, Springfield, MO 65807-7310 | 2020-04-30 |
| 1992326193 | Mark L Vandersnick | Physical Therapist | 3545 S National Ave, Springfield, MO 65807-7310 | 2020-04-29 |
| 1043831381 | Ronald Lee Sapp I | Physical Therapist | 3545 S National Ave, Springfield, MO 65807-7310 | 2020-04-28 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62711 |
Please comment or provide details below to improve the information on MR. H. RUFFIN WALDEN III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.