Active NPI
Charles Ruebelmann, FNP-C, APRN
- Primary Care Nurse Practitioner
- Salt Lake City, UT
National Provider Identifier
1053330530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- 342053-4405
- Practice address
- Veterans Administration Medical Cente500 Foothill Blvd
Salt Lake City, UT 84148-0001 - Phone
- (801) 582-1565
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 342053-4405 | UT | Primary |
Addresses
Primary practice location
Veterans Administration Medical Cente500 Foothill Blvd
Salt Lake City, UT 84148-0001
Mailing address
3699 South Twinbrook Street
Salt Lake City, UT 84109
Phone (801) 274-7140
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
| License | State | Type | Specialty |
|---|---|---|---|
| 342053-4405 | UT | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053330530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3699 SOUTH TWINBROOK STREET",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84109",
"telephone_number": "801-274-7140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "VETERANS ADMINISTRATION MEDICAL CENTE500 FOOTHILL BLVD",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841480001",
"telephone_number": "801-582-1565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUEBELMANN",
"first_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "FNP-C, APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "UT",
"license": "342053-4405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.