Individual provider Active NPI

John C Ruggian, MD

  • Internal Medicine Physician
  • Port St Lucie, FL
National Provider Identifier
1699778027
Registry record updated Jun 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME67996 Issued in FL
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

Updated by the provider on Jun 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
28228OtherFLBLUECROSS 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

LicenseStateTypeSpecialty
ME67996FLMDNephrology 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.

Verify at the official NPI Registry.