Individual provider Active NPI

David A. Ruble, LPE-I

  • Mental Health Counselor
  • Conway, AR
National Provider Identifier
1104955814
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
95-11EI Issued in AR
Practice address
505 Amity Rd Ste 604
Conway, AR 72032-5993
Phone
(501) 825-3100
Fax
(501) 367-7677
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 95-11EI AR Primary

Addresses

Primary practice location

505 Amity Rd Ste 604
Conway, AR 72032-5993

Mailing address

505 Amity Rd Ste 604
Conway, AR 72032-5993
Phone (501) 825-3100

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
95-11EIARMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Access Counseling & Assessment Services, LLC Mental Health CurrentSince Feb 14, 2021 Accepting new patients
United Methodist Children'S Home, Inc. Past Accepting new patients

Locations

505 Amity Rd
Ste 604
Conway, AR 72032
Phone (501) 825-3100

Organizations & group practices 2

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1104955814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 AMITY RD STE 604",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325993",
            "telephone_number": "501-825-3100",
            "fax_number": "501-367-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 AMITY RD STE 604",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325993",
            "telephone_number": "501-825-3100",
            "fax_number": "501-367-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBLE",
        "first_name": "DAVID",
        "middle_name": "A.",
        "name_prefix": "Mr.",
        "credential": "LPE-I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AR",
            "license": "95-11EI",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.