Individual provider Active NPI

Richard Henry Rubes, PHD

  • Clinical Psychologist
  • Fort Drum, NY
National Provider Identifier
1174539043
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
P648 Issued in TN
Practice address
Bldng P11050 Mount Belvedere Blvd
Guthrie Ambulatory Health Clinic
Fort Drum, NY 13602
Phone
(315) 772-1074
Fax
(315) 772-6229
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X P648 TN Primary

Addresses

Primary practice location

Bldng P11050 Mount Belvedere Blvd
Guthrie Ambulatory Health Clinic
Fort Drum, NY 13602

Mailing address

Bldng P11050 Mount Belvedere Blvd
Guthrie Ambulatory Health Clinic
Fort Drum, NY 13602
Phone (315) 772-1074

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
P648TNMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1174539043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BLDNG P11050 MOUNT BELVEDERE BLVD",
            "address_2": "GUTHRIE AMBULATORY HEALTH CLINIC",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-1074",
            "fax_number": "315-772-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDNG P11050 MOUNT BELVEDERE BLVD",
            "address_2": "GUTHRIE AMBULATORY HEALTH CLINIC",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "13602",
            "telephone_number": "315-772-1074",
            "fax_number": "315-772-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBES",
        "first_name": "RICHARD",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TN",
            "license": "P648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Drum, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.