Active NPI
Thomas Wruk
- General Practice Registered Nurse
- West Yarmouth, MA
National Provider Identifier
1174378657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Registered Nurse
- License
- RN2366481
- Practice address
- 349 Route 28 Ste a
West Yarmouth, MA 02673-4620 - Phone
- (508) 394-2017
- NPI assigned
- Apr 18, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Registered Nurse | 163WG0000X | RN2366481 | MA | Primary |
Addresses
Primary practice location
349 Route 28 Ste a
West Yarmouth, MA 02673-4620
Mailing address
27 Harbor Hill Run
South Yarmouth, MA 02664-2120
Phone (774) 212-5286
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 |
|---|---|---|---|
| RN2366481 | MA | MD | General Practice Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713398400000",
"number": "1174378657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 HARBOR HILL RUN",
"city": "SOUTH YARMOUTH",
"state": "MA",
"postal_code": "026642120",
"telephone_number": "774-212-5286",
"fax_number": "774-212-5286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "349 ROUTE 28 STE A",
"city": "WEST YARMOUTH",
"state": "MA",
"postal_code": "026734620",
"telephone_number": "508-394-2017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRUK",
"first_name": "THOMAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-04-18",
"last_updated": "2024-04-18",
"certification_date": "2024-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "MA",
"license": "RN2366481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Yarmouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.