Individual provider Active NPI

Lisa A Ruohoniemi, MD

  • Pediatrics Physician
  • Seneca, SC
National Provider Identifier
1679819965
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35269 Issued in SC
Practice address
10706 Clemson Blvd
Seneca, SC 29678-4528
Phone
(864) 888-3020
Fax
(864) 888-8585
NPI assigned
Dec 14, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35269 SC Primary

Addresses

Primary practice location

10706 Clemson Blvd
Seneca, SC 29678-4528

Mailing address

10706 Clemson Blvd
Seneca, SC 29678-4528
Phone (864) 888-3020

Other names 1

  • Lisa A Lark Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35269SCMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: lruohoniemi7995@direct.anmedhealth.net

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355443200000",
    "number": "1679819965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10706 CLEMSON BLVD",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784528",
            "telephone_number": "864-888-3020",
            "fax_number": "864-888-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10706 CLEMSON BLVD",
            "city": "SENECA",
            "state": "SC",
            "postal_code": "296784528",
            "telephone_number": "864-888-3020",
            "fax_number": "864-888-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUOHONIEMI",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "SC",
            "license": "35269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LARK",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seneca, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; 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.