Individual provider Active NPI

Dawn Ruminski, D.O.

  • General Practice Physician
  • Fort Rucker, AL
National Provider Identifier
1710120316
Registry record updated Jun 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2018-02852 Issued in NC
Practice address
301 Andrews Avenue
Fort Rucker, AL 36362
Phone
(334) 255-7650
NPI assigned
Apr 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 1103 AL
General Practice Physician 208D00000X 2018-02852 NC Primary

Addresses

Primary practice location

301 Andrews Avenue
Fort Rucker, AL 36362

Mailing address

2932 Walden Rd
Fayetteville, NC 28303-3867
Phone (828) 551-0285

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200114001878 NC Practitioner - General Practice 1658706916 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
West Virginia School of Osteopathic Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Physical Medicine PAGroup PAC ID 0547554008, 2 clinicians

Practice addresses (Care Compare)

3706 Morganton Rd
Fayetteville, NC 28303-4963
Phone (910) 867-5500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2018-02852NCMDGeneral Practice Physician
1103ALMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Physical Medicine PA General Practice CurrentSince Dec 1, 2019 Accepting new patients

Locations

3706 Morganton Rd
Fayetteville, NC 28303
Phone (910) 867-5500

Organizations & group practices 1

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": "1239580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560556800000",
    "number": "1710120316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2932 WALDEN RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283033867",
            "telephone_number": "828-551-0285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ANDREWS AVENUE",
            "city": "FORT RUCKER",
            "state": "AL",
            "postal_code": "36362",
            "telephone_number": "334-255-7650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUMINSKI",
        "first_name": "DAWN",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-13",
        "last_updated": "2019-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AL",
            "license": "1103",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NC",
            "license": "2018-02852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Rucker, AL

Sources for this page

Verify at the official NPI Registry.