Ruthe Annelus, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F11220276 Issued in CA

Practice address

345 Tobin Ave
Angwin, CA 94508-9775

Phone

(407) 616-2057

NPI assigned

Nov 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: ruthe.annelus.1@30147.direct.athenahealth.com

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1033828264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 323",
            "city": "ANGWIN",
            "state": "CA",
            "postal_code": "945080323",
            "telephone_number": "407-616-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 TOBIN AVE",
            "city": "ANGWIN",
            "state": "CA",
            "postal_code": "945089775",
            "telephone_number": "407-616-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNELUS",
        "first_name": "RUTHE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F11220276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crestwood Behavioral Health, Inc.
• Sandra Carol Dawood, PHD
• Donald R. Wilson, M.D., Inc.
• Douglas Mosher DC Inc
• Kendell Eakle, DPT

• Family Nurse Practitioner in Angwin, CA
• Providers in Angwin, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.