Active NPI
Ethan Baruch Ruben, M.D.
- Pediatrics Physician
- Scottsboro, AL
National Provider Identifier
1659343200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 00006466
- Practice address
- 508 Harley St
Suite C
Scottsboro, AL 35768-4294 - Phone
- (256) 259-5537
- Fax
- (256) 259-3189
- NPI assigned
- Feb 6, 2006
- Last updated
- Apr 19, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 00006466 | AL | Primary |
Addresses
Primary practice location
508 Harley St
Suite C
Scottsboro, AL 35768-4294
Mailing address
508 Harley St
Suite C
Scottsboro, AL 35768-4294
Phone (256) 259-5537
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00006466 | AL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BHC-Medstat of Jasper | Past | Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Physician
- Jasper, AL
- NPI 1013115294
-
dba Ozarks Healthcare
- General Acute Care Hospital
- West Plains, MO
- NPI 1831115641
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271635200000",
"number": "1659343200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 HARLEY ST",
"address_2": "SUITE C",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357684294",
"telephone_number": "256-259-5537",
"fax_number": "256-259-3189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 HARLEY ST",
"address_2": "SUITE C",
"city": "SCOTTSBORO",
"state": "AL",
"postal_code": "357684294",
"telephone_number": "256-259-5537",
"fax_number": "256-259-3189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBEN",
"first_name": "ETHAN",
"middle_name": "BARUCH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-06",
"last_updated": "2010-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "00006466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scottsboro, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.