Individual provider Active NPI

Ruby Joy Maez, R.N.

  • Registered Nurse
  • Pueblo, CO
National Provider Identifier
1508903790
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
30194 Issued in CO
Practice address
151 Central Main St
Pueblo, CO 81003-4212
Phone
(719) 583-4362
Fax
(719) 583-4439
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 30194 CO Primary

Addresses

Primary practice location

151 Central Main St
Pueblo, CO 81003-4212

Mailing address

3713 Sheffield LN
Pueblo, CO 81005-3269
Phone (719) 583-4362

Other identifiers 1

IdentifierTypeStateIssuer
07301948MedicaidCO

Other names 1

  • Miss Ruby Joy Duran Former name

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
30194COMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508903790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3713 SHEFFIELD LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053269",
            "telephone_number": "719-583-4362",
            "fax_number": "719-583-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 CENTRAL MAIN ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810034212",
            "telephone_number": "719-583-4362",
            "fax_number": "719-583-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAEZ",
        "first_name": "RUBY",
        "middle_name": "JOY",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "30194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07301948",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUBY",
            "last_name": "DURAN",
            "middle_name": "JOY",
            "prefix": "MISS",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

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.

Verify at the official NPI Registry.