Active NPI
Ruth Wingate Allen, PA
- Physician Assistant
- Gulf Breeze, FL
National Provider Identifier
1104805480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 9109540
- Practice address
- 3416 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-1401 - Phone
- (850) 934-5713
- NPI assigned
- Jan 13, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 9109540 | FL | Primary |
Addresses
Primary practice location
3416 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-1401
Mailing address
3416 Gulf Breeze Pkwy
Gulf Breeze, FL 32563-1401
Phone (850) 934-5713
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 9109540 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Pain Physicians PC | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467590400000",
"number": "1104805480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3416 GULF BREEZE PKWY",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325631401",
"telephone_number": "850-934-5713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3416 GULF BREEZE PKWY",
"city": "GULF BREEZE",
"state": "FL",
"postal_code": "325631401",
"telephone_number": "850-934-5713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "RUTH",
"middle_name": "WINGATE",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-13",
"last_updated": "2016-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA 9109540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulf Breeze, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.