Individual provider Active NPI

Simone Akila Ruskamp, LGSW

  • Social Worker
  • Washington, DC
National Provider Identifier
1184320269
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LG200001856 Issued in DC
Practice address
4215 Illinois Ave NW
Washington, DC 20011-5951
Phone
(510) 860-2825
NPI assigned
Feb 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LG200001856 DC Primary

Addresses

Primary practice location

4215 Illinois Ave NW
Washington, DC 20011-5951

Mailing address

4215 Illinois Ave NW
Washington, DC 20011-5951
Phone (510) 860-2825

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
LG200001856DCMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1184320269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 ILLINOIS AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115951",
            "telephone_number": "510-860-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 ILLINOIS AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200115951",
            "telephone_number": "510-860-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSKAMP",
        "first_name": "SIMONE",
        "middle_name": "AKILA",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "DC",
            "license": "LG200001856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.