Individual provider Active NPI

Jakki Ruzich

  • Occupational Therapist
  • Boulder, CO
National Provider Identifier
1033472394
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
12666 Issued in CA
Practice address
3850 Paseo del Prado St Apt 36
Boulder, CO 80301-1592
Phone
(702) 612-7533
NPI assigned
Jun 21, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 12666 CA Primary

Addresses

Primary practice location

3850 Paseo del Prado St Apt 36
Boulder, CO 80301-1592

Mailing address

3850 Paseo del Prado St Apt 36
Boulder, CO 80301-1592

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12666CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1033472394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 PASEO DEL PRADO ST APT 36",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 PASEO DEL PRADO ST APT 36",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803011592",
            "telephone_number": "702-612-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZICH",
        "first_name": "JAKKI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "12666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.