Individual provider Active NPI

Jarod Randall Ruffing

  • General Practice Dentistry
  • Greenville, NC
National Provider Identifier
1558043869
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0000000000 Issued in NC
Practice address
2225 Sweet Bay Dr Unit a
Greenville, NC 27834-2535
Phone
(907) 355-5711
NPI assigned
Aug 4, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0000000000 NC Primary

Addresses

Primary practice location

2225 Sweet Bay Dr Unit a
Greenville, NC 27834-2535

Mailing address

2225 Sweet Bay Dr Unit a
Greenville, NC 27834-2535
Phone (907) 355-5711

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

State licenses

LicenseStateTypeSpecialty
0000000000NCMDEmergency Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1691107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1558043869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 SWEET BAY DR UNIT A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342535",
            "telephone_number": "907-355-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 SWEET BAY DR UNIT A",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342535",
            "telephone_number": "907-355-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFING",
        "first_name": "JAROD",
        "middle_name": "RANDALL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-04",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "0000000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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.