Individual provider Active NPI

Bobbie Kristena Ruiz, FNP-BC BSN RN

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1487468906
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN300400 Issued in GA
Practice address
2675 Paces Ferry Rd SE Ste 200
Atlanta, GA 30339-4099
Phone
(678) 813-3775
Fax
(770) 626-3791
NPI assigned
Feb 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN300400 GA Primary

Addresses

Primary practice location

2675 Paces Ferry Rd SE Ste 200
Atlanta, GA 30339-4099

Mailing address

1405 Spring St NW Apt 29M
Atlanta, GA 30309-5148
Phone (678) 278-5489

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250214000359 GA Practitioner - Nurse Practitioner 2466982830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

4072 Atlanta Hwy
Loganville, GA 30052-2297
Phone (678) 905-0236

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN300400GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Immediate Care FP, LLC CurrentSince Feb 4, 2025 Accepting new patients

Locations

590 Lanier Ave W
Fayetteville, GA 30214

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

4072 Atlanta Hwy
Loganville, GA 30052
Phone (678) 905-0236

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1487468906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SPRING ST NW APT 29M",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303095148",
            "telephone_number": "678-278-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 PACES FERRY RD SE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394099",
            "telephone_number": "678-813-3775",
            "fax_number": "770-626-3791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "BOBBIE",
        "middle_name": "KRISTENA",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC BSN RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN300400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.