Individual provider Active NPI

Joseph Connor Ruiz, DPT

  • Sports Physical Therapist
  • Suwanee, GA
National Provider Identifier
1548014335
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
Practice address
4310 Johns Creek Pkwy Ste 130
Suwanee, GA 30024-6092
Phone
(770) 692-1481
Fax
(770) 495-0806
NPI assigned
Apr 16, 2024
Last updated
Apr 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X GA Primary

Addresses

Primary practice location

4310 Johns Creek Pkwy Ste 130
Suwanee, GA 30024-6092

Mailing address

4310 Johns Creek Pkwy Ste 130
Suwanee, GA 30024-6092
Phone (770) 757-3058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240529003506 GA Practitioner - Physical Therapist in Private Practice 1355783838 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sportscare Physical Therapy, IncGroup PAC ID 3274546197, 9 clinicians

Practice addresses (Care Compare)

4310 Johns Creek Pkwy
Suite 130
Suwanee, GA 30024-6092
Phone (770) 495-0610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sportscare Physical Therapy Inc CurrentSince Apr 17, 2024 Accepting new patients

Locations

3655 Howell Ferry Rd
Ste 300
Duluth, GA 30096
Phone (678) 828-2194

4310 Johns Creek Pkwy
Ste 130
Suwanee, GA 30024
Phone (770) 495-0610

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1548014335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 JOHNS CREEK PKWY STE 130",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246092",
            "telephone_number": "770-757-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 JOHNS CREEK PKWY STE 130",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246092",
            "telephone_number": "770-692-1481",
            "fax_number": "770-495-0806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JOSEPH",
        "middle_name": "CONNOR",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.