Individual provider Active NPI

Ruth Ethel Pflueger, NP, PA

  • Nurse Practitioner
  • Modesto, CA
National Provider Identifier
1518155175
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
332272 Issued in CA
Practice address
1300 Mable Ave
Modesto, CA 95355-1120
Phone
(209) 571-1992
Fax
(209) 571-1994
NPI assigned
Oct 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 16946 CA
Nurse Practitioner 363L00000X 332272 CA Primary

Addresses

Primary practice location

1300 Mable Ave
Modesto, CA 95355-1120

Mailing address

1300 Mable Ave
Modesto, CA 95355-1120
Phone (209) 571-1992

Other identifiers 2

IdentifierTypeStateIssuer
332272OtherCANP LICENSE
16946OtherCAPA LICENSE

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)
Enrolled
Credentials
Nurse Practitioner, Physician Assistant

State licenses

LicenseStateTypeSpecialty
332272CAMDNurse Practitioner
4364CAMDAcute Care Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1518155175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 MABLE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551120",
            "telephone_number": "209-571-1992",
            "fax_number": "209-571-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MABLE AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953551120",
            "telephone_number": "209-571-1992",
            "fax_number": "209-571-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFLUEGER",
        "first_name": "RUTH",
        "middle_name": "ETHEL",
        "name_prefix": "Mrs.",
        "credential": "NP, PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "16946",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "332272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "332272",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "16946",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.