Ruby Fairchild

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

LG-0001187 Issued in DE

Practice address

489 5TH Ave FL 3
New York, NY 10017-6145

Phone

(212) 440-0658

NPI assigned

Jul 5, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Mass General Brigham Community Physicians Inc.

  • Internal Medicine Physician
  • Haverhill, MA
  • NPI 1891112637
  Medicare reassignment Care Compare group NPD
• Mass General Brigham Community Physicians Inc

  • Cardiovascular Disease Physician
  • Medford, MA
  • NPI 1548638265
  NPD
• Mass General Brigham Community Physicians Inc.

  dba One Medical

  • Family Medicine Physician
  • Boston, MA
  • NPI 1265094122
  NPD

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

{
    "created_epoch": "1499212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1023539509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21444 CARMEAN WAY",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199474572",
            "telephone_number": "302-855-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100176145",
            "telephone_number": "212-440-0658"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Fort Washington Ave Apt 56",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "10032",
            "country_code": "US",
            "telephone_number": "781-467-9060",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21444 Carmean Way",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "DE",
            "postal_code": "199474572",
            "country_code": "US",
            "telephone_number": "302-855-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "28 State St Ste 2860",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021091789",
            "country_code": "US",
            "telephone_number": "617-903-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRCHILD",
        "first_name": "RUBY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-05",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "717179-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DE",
            "license": "LG-0001187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Fair, LCAT, LCSW
• Daniella Marie Fair, PA
• Georgia Grace Fair
• James Anthony Fair
• Fairchild Podiatry PC
• Jessica Collins Fairchilds, FNP, PMHNP
• Nathan Alexander Fairclough I
• Spencer Lacy Fairgrieve, OD
• Stacyann Patricia Fairweather Wills
• Samantha Rose Fairweather

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.