Individual provider Active NPI

Jennifer Marie Ruby, RD, LDN

  • Registered Dietitian
  • Chambersburg, PA
National Provider Identifier
1700188778
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN003625 Issued in PA
Practice address
12 St Paul Dr Ste 210
Chambersburg, PA 17201-1035
Phone
(717) 217-6820
Fax
(717) 217-6942
NPI assigned
Nov 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN003625 PA Primary

Addresses

Primary practice location

12 St Paul Dr Ste 210
Chambersburg, PA 17201-1035

Mailing address

785 5TH Ave Ste 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555

Other practice location 1

24 Antrim Commons Dr
Greencastle, PA 17225-1623
Phone (717) 217-6820

Other practice location 2

601 E Main St
Waynesboro, PA 17268-2332
Phone (717) 217-6820

Other practice location 3

354 Alexander Spring Rd Ste 3
Carlisle, PA 17015-7451
Phone (717) 217-6820

Other identifiers 1

IdentifierTypeStateIssuer
102738231MedicaidPA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120817000042 PA Practitioner - Registered Dietitian Or Nutrition Professional 4486800802 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

12 St Paul Dr
Chambersburg, PA 17201-1035

24 Antrim Commons Dr
Greencastle, PA 17225-1623
Phone (717) 255-0157

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN003625PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Wellspan Medical Group Current Accepting new patients

Locations

354 Alexander Spring Rd
Ste 3
Carlisle, PA 17015
Phone (717) 217-6820

12 St Paul Dr
Ste 210
Chambersburg, PA 17201
Phone (717) 217-6820

24 Antrim Commons Dr
Greencastle, PA 17225
Phone (717) 593-0512

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

601 E Main St
Waynesboro, PA 17268
Phone (717) 765-5085

1600 S George St
York, PA 17403
Phone (717) 848-3615

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1700188778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVE STE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555",
            "fax_number": "717-217-4218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ST PAUL DR STE 210",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011035",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Antrim Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Greencastle",
            "state": "PA",
            "postal_code": "172251623",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 E Main St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "PA",
            "postal_code": "172682332",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "354 Alexander Spring Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170157451",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBY",
        "first_name": "JENNIFER",
        "middle_name": "MARIE",
        "credential": "RD, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-24",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN003625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102738231",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.