Active NPI
Charles W Ruggles, M.D.
- Specialist
- Colorado Springs, CO
National Provider Identifier
1245202845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 19699
- Practice address
- 170 S Parkside Dr
Colorado Springs, CO 80910-3129 - Phone
- (719) 471-1763
- Fax
- (719) 471-2498
- NPI assigned
- Feb 7, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Specialist | 174400000X | 19699 | CO | Primary |
Addresses
Primary practice location
170 S Parkside Dr
Colorado Springs, CO 80910-3129
Mailing address
170 S Parkside Dr
Colorado Springs, CO 80910-3129
Phone (719) 471-1763
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06D0517138 | Other | CO | CLIA |
| 04-15064 | Other | KS | KANSAS LICENSE |
| 01196997 | Medicaid | CO | |
| 100127700A | Medicaid | KS | |
| 19677 | Other | CO | COLORADO LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101105000841 | CO | Practitioner - Dermatology | 7618932351 | Practice locations: Colorado Springs, CO |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19699 | CO | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charles W. Ruggles, M.D. | Specialist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Colorado Springs, CO
- NPI 1174595797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1455753600000",
"number": "1245202845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 S PARKSIDE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103129",
"telephone_number": "719-471-1763",
"fax_number": "719-471-2498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 S PARKSIDE DR",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103129",
"telephone_number": "719-471-1763",
"fax_number": "719-471-2498"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUGGLES",
"first_name": "CHARLES",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-07",
"last_updated": "2016-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CO",
"license": "19699",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "06D0517138",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KANSAS LICENSE",
"identifier": "04-15064",
"state": "KS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01196997",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100127700A",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLORADO LICENSE",
"identifier": "19677",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.