Active NPI
Julio Pablo Ruiz, M.D.
- Nephrology Physician
- Memphis, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 25900
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 052203 | Medicaid | TN | |
| 1723309 | Other | CIGNA | |
| 5J496 | Other | AR | BLUE CROSS BLUE SHIELD |
| 0120636 | Medicaid | MS | |
| 3086649 | Medicaid | TN | |
| 125721001 | Medicaid | AR | |
| 4010137 | Other | TN | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR, MS, TN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E0222 | AR | MD | Nephrology Physician |
| 25900 | TN | MD | Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid-South Nephrology Consultants PLLC | Nephrology | Current | 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
- 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.