Individual provider Active NPI

Ruby Deyoung, LPN

  • Licensed Practical Nurse
  • Proctorville, OH
National Provider Identifier
1275869778
Registry record updated Oct 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN107329 Issued in OH
Practice address
47 Township Road 1267
Proctorville, OH 45669-8916
Phone
(304) 730-0907
NPI assigned
Oct 19, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN107329 OH Primary

Addresses

Primary practice location

47 Township Road 1267
Proctorville, OH 45669-8916

Mailing address

47 Township Road 1267
Proctorville, OH 45669-8916
Phone (304) 730-0907

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
PN107329OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255910400000",
    "number": "1275869778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 TOWNSHIP ROAD 1267",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456698916",
            "telephone_number": "304-730-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 TOWNSHIP ROAD 1267",
            "city": "PROCTORVILLE",
            "state": "OH",
            "postal_code": "456698916",
            "telephone_number": "304-730-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEYOUNG",
        "first_name": "RUBY",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2009-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN107329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Proctorville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2009; 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.