Active NPI
Amy Kathleen Ruffolo, PHARMD
- Pharmacist
- Racine, WI
National Provider Identifier
1457468795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 14221-040
- Practice address
- 1320 Wisconsin Ave
Racine, WI 53403-1978 - Phone
- (262) 687-2635
- NPI assigned
- Aug 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 14221-040 | WI | Primary |
Addresses
Primary practice location
1320 Wisconsin Ave
Racine, WI 53403-1978
Mailing address
8223 68TH Ave
Kenosha, WI 53142-1864
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)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14221-040 | WI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457468795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8223 68TH AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531421864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 WISCONSIN AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534031978",
"telephone_number": "262-687-2635"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUFFOLO",
"first_name": "AMY",
"middle_name": "KATHLEEN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "14221-040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Racine, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.