Individual provider Active NPI

Earl C. Ruby, D.O.

  • Family Medicine Physician
  • Midlothian, TX
National Provider Identifier
1396969176
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L0917 Issued in TX
Practice address
4440 E Highway 287
Midlothian, TX 76065-5576
Phone
(972) 723-5590
Fax
(972) 723-5592
NPI assigned
Apr 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L0917 TX Primary

Addresses

Primary practice location

4440 E Highway 287
Midlothian, TX 76065-5576

Mailing address

4440 E Highway 287
Midlothian, TX 76065-5576
Phone (972) 723-5590

Other identifiers 2

IdentifierTypeStateIssuer
030724104MedicaidTX
343164YL7AOtherTXMEDICARE - OTHER

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 Osteopathy, Doctor of Medicine

Interoperability endpoints

  • Direct secure messaging: earl.ruby.1@26849.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1396969176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 E HIGHWAY 287",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760655576",
            "telephone_number": "972-723-5590",
            "fax_number": "972-723-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 E HIGHWAY 287",
            "city": "MIDLOTHIAN",
            "state": "TX",
            "postal_code": "760655576",
            "telephone_number": "972-723-5590",
            "fax_number": "972-723-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBY",
        "first_name": "EARL",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L0917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030724104",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - OTHER",
            "identifier": "343164YL7A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; 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.