Active NPI
Ruth A. Villanueva
- Other Technician
- Saint Clair Shores, MI
National Provider Identifier
1629426291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- 32162474
- Practice address
- 21725 Hoffman St
Saint Clair Shores, MI 48082-2462 - Phone
- (928) 304-2648
- NPI assigned
- May 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | 32162474 | PA | Primary |
Addresses
Primary practice location
21725 Hoffman St
Saint Clair Shores, MI 48082-2462
Mailing address
21725 Hoffman St
Saint Clair Shores, MI 48082-2462
Phone (928) 304-2648
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32162474 | PA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468281600000",
"number": "1629426291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21725 HOFFMAN ST",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480822462",
"telephone_number": "928-304-2648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21725 HOFFMAN ST",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480822462",
"telephone_number": "928-304-2648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLANUEVA",
"first_name": "RUTH",
"middle_name": "A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-24",
"last_updated": "2016-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "PA",
"license": "32162474",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.