Organization Active NPI

Ruffin Medicine LLC

  • Primary Care Clinic/Center
  • Choctaw, OK
National Provider Identifier
1699421941
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
RUFFIN MEDICINE LLC
Practice address
1940 Harper St
Choctaw, OK 73020-8095
Phone
(405) 281-6065
Fax
(405) 281-6068
NPI assigned
Feb 24, 2022
Last updated
Sep 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

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

Authorized official

Name
Dr. Larry L Ruffin, DONPI 1396790143
Title
Owner
Phone
(405) 281-6065

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1940 Harper St
Choctaw, OK 73020-8095

Mailing address

11124 NE 5TH St # NA
Choctaw, OK 73020-7701
Phone (405) 281-6065

Other identifiers 1

IdentifierTypeStateIssuer
200072870BMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220511001414 OK Part B Supplier - Clinic/Group Practice 9133506264 Receives reassigned benefits from 2 practitioners
Practice locations: Choctaw, OK

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
37D2261834Ruffin Family Medicine1940 Harper St, Choctaw, OK 73020Certificate of waiverJun 5, 2028

National Provider Directory

National Provider Directory

Locations

1940 Harper St
Choctaw, OK 73020
Phone (405) 281-5682

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664236800000",
    "number": "1699421941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11124 NE 5TH ST # NA",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730207701",
            "telephone_number": "405-281-6065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 HARPER ST",
            "city": "CHOCTAW",
            "state": "OK",
            "postal_code": "730208095",
            "telephone_number": "405-281-6065",
            "fax_number": "405-281-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUFFIN MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "RUFFIN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-281-6065",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200072870B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Choctaw, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.