Active NPI
Joseph Samuel Ruis II, ATC, LAT
- Athletic Trainer
- Macclenny, FL
National Provider Identifier
1306010939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AL 1600
- Practice address
- 106 E Macclenny Ave
Suite a
Macclenny, FL 32063-2120 - Phone
- (904) 316-9050
- NPI assigned
- Apr 15, 2008
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL 1600 | FL | Primary |
Addresses
Primary practice location
106 E Macclenny Ave
Suite a
Macclenny, FL 32063-2120
Mailing address
PO Box 86
Macclenny, FL 32063-0086
Phone (904) 316-9050
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
| License | State | Type | Specialty |
|---|---|---|---|
| AL 1600 | FL | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1306010939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 86",
"city": "MACCLENNY",
"state": "FL",
"postal_code": "320630086",
"telephone_number": "904-316-9050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 E MACCLENNY AVE",
"address_2": "SUITE A",
"city": "MACCLENNY",
"state": "FL",
"postal_code": "320632120",
"telephone_number": "904-316-9050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIS",
"first_name": "JOSEPH",
"middle_name": "SAMUEL",
"name_prefix": "Mr.",
"name_suffix": "II",
"credential": "ATC, LAT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-04-15",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL 1600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macclenny, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.