Laurie S. Fairall-Rueter, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY 7675 Issued in FL

Practice address

4400 Marsh Landing Blvd
Suite 1
Ponte Vedra Beach, FL 32082-1287

Phone

(904) 463-2284

Fax

(904) 543-7755

NPI assigned

Aug 18, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dr Fairall and Associates Behavioral Health and Family Mediation Servi

  • Psychologist
  • Ponte Vedra Beach, FL
  • NPI 1083088165
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563408000000",
    "number": "1487768248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 MARSH LANDING BLVD",
            "address_2": "SUITE 1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821287",
            "telephone_number": "904-463-2284",
            "fax_number": "904-543-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 MARSH LANDING BLVD",
            "address_2": "SUITE 1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821287",
            "telephone_number": "904-463-2284",
            "fax_number": "904-543-7755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1370 13th Ave S Ste 118",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322503206",
            "country_code": "US",
            "telephone_number": "904-376-3800",
            "fax_number": "904-396-8973",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "302 3rd St Ste 3",
            "address_purpose": "LOCATION",
            "city": "Neptune Beach",
            "state": "FL",
            "postal_code": "322665139",
            "country_code": "US",
            "telephone_number": "904-376-3800",
            "fax_number": "904-376-3998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRALL-RUETER",
        "first_name": "LAURIE",
        "middle_name": "S.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2019-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PY003739",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "36593",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 7675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bateh Engel, LCSW
• Eric S. Burgess, DMD, PA
• Anne Marie Esposito, LMHC
• Stephan M. Esser, M.D.
• Pamela Jeanne Evans, DDS
• Allison Ann Falden, O.D.
• Family Smiles Ponte Vedra
• Larry Feldman, PT
• Courtney Fickling, MHS, OTR/L
• Carla M Field, DDS

• Psychologist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2019; 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.