Individual provider Active NPI

Jenna Ruff, CCC-SLP

  • Speech-Language Pathologist
  • Bismarck, ND
National Provider Identifier
1568093474
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
4530 Northern Sky Dr
Bismarck, ND 58503-8534
Phone
(701) 751-6336
NPI assigned
Jan 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

4530 Northern Sky Dr
Bismarck, ND 58503-8534

Mailing address

4530 Northern Sky Dr
Bismarck, ND 58503-8534
Phone (701) 751-6336

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818002048 ND Practitioner - Qualified Speech Language Pathologist 2062838295 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1827NDMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Therapy Partners, Inc. Speech-Language Pathologist CurrentSince Jul 6, 2020 Accepting new patients
Pediatric Therapy Partners, Inc. CurrentSince Nov 1, 2020 Accepting new patients

Locations

3060 Frontier Way S
Fargo, ND 58104
Phone (701) 356-4384

3401 45th St S
#A
Fargo, ND 58104
Phone (701) 356-4384

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1568093474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 NORTHERN SKY DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038534",
            "telephone_number": "701-751-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 NORTHERN SKY DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038534",
            "telephone_number": "701-751-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFF",
        "first_name": "JENNA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.