NPIMap

Individual provider Active NPI

Charles D Ruis, MD

  • Family Medicine Physician
  • Albany, GA
National Provider Identifier
1275570715
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
030206 Issued in GA
Practice address
1109 N Jackson St
Albany, GA 31701-2022
Phone
(229) 352-4275
Fax
(229) 430-0487
NPI assigned
Jun 1, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 030206 GA Primary

Addresses

Primary practice location

1109 N Jackson St
Albany, GA 31701-2022

Mailing address

1109 N Jackson St
Albany, GA 31701-2022
Phone (229) 352-4275

Other identifiers 1

IdentifierTypeStateIssuer
000365153SMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230926001675 GA Order and Referring Only - General PracticePractitioner - General Practice 5395729297

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
030206GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Sumter Regional Medical Group, PC Past Accepting new patients
Morningside Emergency Physicians LLC Past Accepting new patients
Baker County Board of Health PastSince Apr 1, 2016 Accepting new patients
Unadilla Health Care Center Inc Past Accepting new patients
Americus & Sumter County Hospital Authority Past Accepting new patients
Health Services of Central Georgia, Inc Family Medicine Past Accepting new patients
Taylor Regional Emergency Physicians, LLC Past Accepting new patients
Grady County Board of Health PastSince Apr 1, 2016 Accepting new patients
United Emergency Services, Inc. Past Accepting new patients
Dennis R Thomas MD PC Family Medicine Past Accepting new patients
Dougherty County Board of Health PastSince Apr 1, 2016 Accepting new patients
Miller County Board of Health PastSince Apr 1, 2016 Accepting new patients
Decatur County Board of Health Past Accepting new patients
Colquitt County Board of Health PastSince Apr 1, 2016 Accepting new patients
Inphynet Primary Care Physicians Southeast PC Past Accepting new patients
Acs Primary Care Physicians - Southeast PC Past Accepting new patients
Calhoun County Board of Health PastSince Apr 1, 2016 Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Robert Harvey Elementary School-Based Health CenterAlbany, GA, CCN 111083 Federally qualified health center Corporate Director Jul 1, 2016
Live Oak Elementary School-Based Health CenterAlbany, GA, CCN 111081 Federally qualified health center Corporate Director Jul 1, 2016

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 25

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1275570715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N JACKSON ST",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317012022",
            "telephone_number": "229-352-4275",
            "fax_number": "229-430-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 N JACKSON ST",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317012022",
            "telephone_number": "229-352-4275",
            "fax_number": "229-430-0487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIS",
        "first_name": "CHARLES",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "030206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000365153S",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

Verify at the official NPI Registry.