Holli K Ruby, DO
Individual provider Active NPI Family Medicine Physician · Ava, MO
NPI 1508801580 · NPPES record last updated Oct 26, 2015
Key facts
- NPI
- 1508801580
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 118003 (MO)
- Practice address
- 504 NW 10TH Ave.
Ava, MO 65608-1359 - Phone
- (417) 683-4831
- Fax
- (417) 683-1602
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Douglas County Public Health Services Group, Inc. | Past | Accepting new patients | |
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 118003 | MO | Yes |
Addresses
Primary practice location
504 NW 10TH Ave.
Ava, MO 65608-1359
Mailing address
PO Box 1359
Ava, MO 65608-1359
Phone (417) 683-4831
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148980 | Other | BCBS | |
| 243912714 | Medicaid | MO | |
| 389677 | Other | HEALTHLINK | |
| 080174612 | Other | RAILROAD MEDICARE |
Other providers in Ava, MO
- Quality Counseling Services LLC
- Kelley Renee Reed
- Regional Services
- Cara Roberts
- Lise G Rogers
- Scott Mason DDS
- Alisa Leanna Shebiel
- Teresa Lynn Sherard
- Smith Management Services, LLC
- Grace Smith
All providers in Ava, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.