Jon Alfredo Ruiz, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4852194-3101 Issued in UT

Practice address

750 N Freedom Blvd
Provo, UT 84601-1677

Phone

(801) 373-4760

Fax

(801) 373-0639

NPI assigned

Jan 24, 2020

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

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": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1457981797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-373-4760",
            "fax_number": "801-373-0639"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "151 S University Ave Ste 3200",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846014427",
            "country_code": "US",
            "telephone_number": "801-851-7128",
            "fax_number": "801-851-7102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JON",
        "middle_name": "ALFREDO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-01-24",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "UT",
            "license": "4852194-3101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenara Rubio
• Sadie A Rubio
• Joann Nybo Rueckert
• Amanda Ruiz, CSW
• Caleb Ruiz
• Tanya Rummler
• Berkeley Runia
• Patricia Marie Runyan, MPA
• Samuel Runyan
• Todd W Rupper, CMCH

• Licensed Practical Nurse in Provo, UT
• Providers in Provo, UT by specialty
• Licensed Practical Nurse in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; 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.