Individual provider Active NPI

Brandon S Ruble, NP

  • Acute Care Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1396255493
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2017037191 Issued in MO
Practice address
3801 S National Ave Ste 700
Springfield, MO 65807-5210
Phone
(417) 885-3888
Fax
(417) 881-7268
NPI assigned
Oct 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2010029945 MO
Acute Care Nurse Practitioner 363LA2100X 2017037191 MO Primary

Addresses

Primary practice location

3801 S National Ave Ste 700
Springfield, MO 65807-5210

Mailing address

1411 E Primrose St Ste C
Springfield, MO 65804-4377
Phone (417) 882-1207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171025000400 MO Practitioner - Nurse Practitioner 2163798851 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3801 S National Ave
Suite 700
Springfield, MO 65807-5210
Phone (417) 885-3888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2010029945MOMDRegistered Nurse
2017037191MOMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Neurological Institute, L.L.C. CurrentSince Sep 15, 2021 Accepting new patients
Springfield Neurological Institute, L.L.C. CurrentSince Sep 15, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 22, 2017 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 22, 2017 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 22, 2017 Accepting new patients
Neurological and Spine Institute of the Ozarks LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1411 E Primrose St
Ste C
Springfield, MO 65804
Phone (417) 882-1207

3801 S National Ave
Springfield, MO 65807
Phone (417) 269-4056

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

3801 S National Ave
Ste 700
Springfield, MO 65807
Phone (417) 882-1207

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

Organizations & group practices 7

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1396255493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 E PRIMROSE ST STE C",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658044377",
            "telephone_number": "417-882-1207",
            "fax_number": "417-881-7268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 S NATIONAL AVE STE 700",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075210",
            "telephone_number": "417-885-3888",
            "fax_number": "417-881-7268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBLE",
        "first_name": "BRANDON",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-04",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2010029945",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MO",
            "license": "2017037191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.