Active NPI
John C Ruggian, MD
- Internal Medicine Physician
- Port St Lucie, FL
National Provider Identifier
1699778027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME67996
- Practice address
- 782 E. Prima Vista Blvd
Port St. Lucie, FL 34952-0000 - Phone
- (772) 340-0923
- Fax
- (772) 340-4462
- NPI assigned
- May 31, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | ME67996 | FL | Primary |
| Nephrology Physician | 207RN0300X | ME67996 | FL |
Addresses
Primary practice location
782 E. Prima Vista Blvd
Port St. Lucie, FL 34952-0000
Mailing address
782 E. Prima Vista Blvd
Port St. Lucie, FL 34952-0000
Phone (772) 340-0923
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28228 | Other | FL | BLUECROSS BLUESHIELD |
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 |
|---|---|---|---|
| ME67996 | FL | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277769600000",
"number": "1699778027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "782 E. PRIMA VISTA BLVD",
"city": "PORT ST. LUCIE",
"state": "FL",
"postal_code": "349520000",
"telephone_number": "772-340-0923",
"fax_number": "772-340-4462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "782 E. PRIMA VISTA BLVD",
"city": "PORT ST. LUCIE",
"state": "FL",
"postal_code": "349520000",
"telephone_number": "772-340-0923",
"fax_number": "772-340-4462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUGGIAN",
"first_name": "JOHN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-05-31",
"last_updated": "2010-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME67996",
"primary": true
},
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "FL",
"license": "ME67996",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUESHIELD",
"identifier": "28228",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.