Active NPI
Jennifer R. Rubin, D.O.
- Psychiatry Physician
- Phoenix, AZ
National Provider Identifier
1194778407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 3925
- Practice address
- 1130 E Missouri Ave
Suite 500
Phoenix, AZ 85014-2718 - Phone
- (602) 246-9639
- NPI assigned
- May 18, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 3925 | AZ | Primary |
Addresses
Primary practice location
1130 E Missouri Ave
Suite 500
Phoenix, AZ 85014-2718
Mailing address
1130 E Missouri Ave
Suite 500
Phoenix, AZ 85014-2718
Phone (602) 246-9639
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3925 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1194778407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 E MISSOURI AVE",
"address_2": "SUITE 500",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850142718",
"telephone_number": "602-246-9639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 E MISSOURI AVE",
"address_2": "SUITE 500",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850142718",
"telephone_number": "602-246-9639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBIN",
"first_name": "JENNIFER",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-18",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "AZ",
"license": "3925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.