Individual provider Active NPI

Julio Pablo Ruiz, M.D.

  • Nephrology Physician
  • Memphis, TN
National Provider Identifier
1629047600
Registry record updated Aug 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
25900 Issued in TN
Practice address
6490 Mount Moriah Road Ext
Suite 200
Memphis, TN 38115-3729
Phone
(901) 565-0244
Fax
(901) 565-0616
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 25900 TN Primary
Nephrology Physician 207RN0300X E0222 AR
Nephrology Physician 207RN0300X 14580 MS

Addresses

Primary practice location

6490 Mount Moriah Road Ext
Suite 200
Memphis, TN 38115-3729

Mailing address

PO Box 752743
Memphis, TN 38175-2743
Phone (901) 565-0244

Other identifiers 7

IdentifierTypeStateIssuer
052203MedicaidTN
1723309OtherCIGNA
5J496OtherARBLUE CROSS BLUE SHIELD
0120636MedicaidMS
3086649MedicaidTN
125721001MedicaidAR
4010137OtherTNBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR, MS, TN3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20101109000629 AR Practitioner - Nephrology 7810979226 Reassigns benefits to 1 organization
I20101118000773 MS Practitioner - Nephrology 7810979226 Reassigns benefits to 1 organization
I20101120000100 TN Practitioner - Nephrology 7810979226 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E0222ARMDNephrology Physician
25900TNMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Nephrology Consultants PLLC Nephrology CurrentSince Jul 1, 1994 Accepting new patients

Locations

1001 E Moultrie Dr
Blytheville, AR 72315
Phone (870) 762-7700

902 Holiday Dr
Ste 106
Forrest City, AR 72335
Phone (870) 494-3025

310 S Rhodes St
West Memphis, AR 72301
Phone (870) 735-5445

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

363 Southcrest Cir
Ste 301
Southaven, MS 38671

7318 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-2548

155 Crescent Dr
Collierville, TN 38017
Phone (901) 861-8041

2047 Highway 51 S
Covington, TN 38019
Phone (901) 475-1555

1995 Highway 51 S
Ste 208
Covington, TN 38019
Phone (901) 476-7070

6490 Mount Moriah Road Ext
Ste 200
Memphis, TN 38115

448 N 2nd St
Memphis, TN 38105
Phone (901) 475-1555

Interoperability endpoints

  • Direct secure messaging: jruiz27734@mlh.direct-ci.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281484800000",
    "number": "1629047600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 752743",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381752743",
            "telephone_number": "901-565-0244",
            "fax_number": "901-565-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6490 MOUNT MORIAH ROAD EXT",
            "address_2": "SUITE 200",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381153729",
            "telephone_number": "901-565-0244",
            "fax_number": "901-565-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "JULIO",
        "middle_name": "PABLO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2010-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "TN",
            "license": "25900",
            "primary": true
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "AR",
            "license": "E0222",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "14580",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "052203",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1723309",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5J496",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0120636",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3086649",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125721001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4010137",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.