Individual provider Active NPI

Ruth Ann Dubbelman Jenny

  • Certified Registered Nurse Anesthetist
  • Raleigh, NC
National Provider Identifier
1447710496
Registry record updated Sep 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6462 Issued in NC
Practice address
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone
(919) 350-8000
NPI assigned
Mar 24, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 280387 NC
Certified Registered Nurse Anesthetist 367500000X 128314 NC
Certified Registered Nurse Anesthetist 367500000X 6462 NC Primary

Addresses

Primary practice location

3000 New Bern Ave
Raleigh, NC 27610-1231

Mailing address

8815 Commons Townes Dr
Raleigh, NC 27616-8083
Phone (919) 771-3295

Other names 1

  • Ms. Ruth Ann Dubbelman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201112000419 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 5991115453 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granville Health SystemGroup PAC ID 1052223757, 78 clinicians
Providence Anesthesiology Associates PAGroup PAC ID 3971566761, 218 clinicians
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

1010 College St
Oxford, NC 27565-2507
Phone (919) 690-3000

1918 Randolph Rd
Suite 740
Charlotte, NC 28207-1167
Phone (704) 316-0810

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

  • Granville Health Systems Hospital, Oxford, NC, CCN 340127
  • Duke Regional Hospital Hospital, Durham, NC, CCN 340155
  • North Carolina Specialty Hospital Hospital, Durham, NC, CCN 340049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6462NCMDGeneral Practice Dentistry
128314NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Oct 9, 2020 Accepting new patients
American Anesthesiology of North Carolina, PLLC Anesthesiology CurrentSince Oct 9, 2020 Accepting new patients
Providence Anesthesiology Associates, P.a. Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
Granville Health System Nurse Anesthetist, Certified Registered CurrentSince Dec 9, 2024 Accepting new patients
Regional Anesthesia, PLLC CurrentSince Feb 27, 2023 Accepting new patients
Raleigh Medical Group, PA CurrentSince Mar 5, 2024 Accepting new patients
Granville Health System CurrentSince Dec 9, 2024 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Sep 24, 2023 Accepting new patients

Locations

1918 Randolph Rd
Ste 740
Charlotte, NC 28207
Phone (704) 316-0810

131 Providence Rd
Ste 200
Charlotte, NC 28207
Phone 70474958001101

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

1010 College St
Oxford, NC 27565
Phone (919) 623-5115

4420 Lake Boone Trl
Raleigh, NC 27607
Phone (919) 784-3034

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

2601 Lake Dr
Ste 201
Raleigh, NC 27607
Phone (919) 783-4888

3100 Spring Forest Rd
Ste 130
Raleigh, NC 27616
Phone (919) 882-0705

3521 Haworth Dr
Raleigh, NC 27609
Phone (919) 782-1806

2402 Camden St SW
Ste 300
Wilson, NC 27893
Phone (252) 237-4100

Organizations & group practices 8

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 4

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": "1553385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1447710496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8815 COMMONS TOWNES DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276168083",
            "telephone_number": "919-771-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101231",
            "telephone_number": "919-350-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNY",
        "first_name": "RUTH",
        "middle_name": "ANN DUBBELMAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-24",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "280387",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "128314",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUTH",
            "last_name": "DUBBELMAN",
            "middle_name": "ANN",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.