Dan Ruffner, LAT, USAW

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

211-39 Issued in WI

Practice address

2001 Alford Park Dr
Kenosha, WI 53140-1994

Phone

(262) 551-5741

NPI assigned

Mar 12, 2020

Last updated

Mar 12, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1583971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1376179101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 ALFORD PARK DR",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401994",
            "telephone_number": "262-945-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 ALFORD PARK DR",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531401994",
            "telephone_number": "262-551-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFNER",
        "first_name": "DAN",
        "name_prefix": "Mr.",
        "credential": "LAT, USAW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-12",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "211-39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Kenosha",
            "affiliation": "N",
            "address_1": "2001 Alford Park Dr",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531401994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronald Rubin, M.D.
• Rita Rucinski
• Hailey Rae Rueth, COTA
• Lawrence Rufer, MD
• Crystal D Ruffin, MD
• Stefanie Ruffolo, M.D.
• Luis Daniel Ruiz Gonzalez, RDH
• Tara R Rullman, MA
• Kirsten Runnalls, BS, MS, OTR/L
• Michelle M. Runnion, MS, LPC

• Athletic Trainer in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2020; 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.