Dr. Laurie Fairall-Rueter, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 7675 Issued in FL

Legal business name

DR. LAURIE FAIRALL-RUETER, LLC

Practice address

4400 Marsh Landing Blvd
Suite 1
Ponte Vedra Beach, FL 32082-1287

Phone

(904) 463-2284

Fax

(904) 543-7755

NPI assigned

Mar 4, 2010

Last updated

Apr 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Laurie Fairall-Rueter, PSY.D.NPI 1487768248

Title

Licensed Psychologist

Phone

(904) 463-2284

Specialties & licenses 3

Addresses

Other names 1

• Laurie Fairall-Rueter Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Laurie S. Fairall-Rueter, PSY.D.

  • Psychologist
  • Ponte Vedra Beach, FL
  • NPI 1487768248
  Authorized official Same address or phone

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

{
    "created_epoch": "1267660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1669795761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 MARSH LANDING BLVD",
            "address_2": "SUITE 1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821287",
            "telephone_number": "904-463-2284",
            "fax_number": "904-543-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 MARSH LANDING BLVD",
            "address_2": "SUITE 1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320821287",
            "telephone_number": "904-463-2284",
            "fax_number": "904-543-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LAURIE FAIRALL-RUETER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-04",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "FAIRALL-RUETER",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "904-463-2284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 7675",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "36593",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PY003739",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laurie Fairall-Rueter",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Psychologist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.