Individual provider Active NPI

Marshall D. Ruffin Jr., M.D.

  • Internal Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1366607855
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101033628 Issued in VA
Practice address
1215 Lee St
PCC, Floor 1
Charlottesville, VA 22908-0001
Phone
(434) 924-6996
NPI assigned
Jul 23, 2008
Last updated
Apr 24, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101033628 VA Primary

Addresses

Primary practice location

1215 Lee St
PCC, Floor 1
Charlottesville, VA 22908-0001

Mailing address

1215 Lee St
PCC, Floor 1
Charlottesville, VA 22908-0001
Phone (434) 924-6996

Other identifiers 1

IdentifierTypeStateIssuer
1366607855MedicaidVA

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 Medicine

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1366607855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "PCC, FLOOR 1",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-924-6996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LEE ST",
            "address_2": "PCC, FLOOR 1",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229080001",
            "telephone_number": "434-924-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "MARSHALL",
        "middle_name": "D.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101033628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366607855",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.