Active NPI
Nori Y Ruo, MD
- Pediatrics Physician
- Douglas, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD059349L
- Practice address
- 815 E 15TH St
Douglas, AZ 85607-1631 - Phone
- (520) 364-5437
- Fax
- (520) 364-4261
- NPI assigned
- Jun 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD059349L | PA | Primary |
Addresses
Primary practice location
815 E 15TH St
Douglas, AZ 85607-1631
Mailing address
1205 F Ave
Douglas, AZ 85607-1920
Phone (520) 364-1429
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001606226 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD059349L | PA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chiricahua Community Health Centers, Inc. | Current | Accepting new patients | |
| Chiricahua Community Health Centers, Inc | Current | Accepting new patients |
Locations
335 S Ocotillo St
Benson, AZ 85602
Phone (520) 326-4811
108 Arizona St
Bisbee, AZ 85603
Phone (520) 432-3309
1111 N F Ave
Douglas, AZ 85607
Phone (520) 364-6860
1100 N F Ave
Douglas, AZ 85607
Phone (520) 364-3285
1205 N F Ave
Douglas, AZ 85607
Phone (520) 364-6852
1151 E 16th St
Douglas, AZ 85607
Phone (520) 364-5437
815 E 15th St
Douglas, AZ 85607
Phone (520) 364-5437
10566 N Highway 191
Elfrida, AZ 85610
Phone (520) 642-2222
4755 Campus Dr
Sierra Vista, AZ 85635
Phone (520) 226-3020
155 Calle Portal
Ste 700
Sierra Vista, AZ 85635
Phone (520) 459-0203
4525 Campus Dr
Sierra Vista, AZ 85635
Phone (520) 459-5959
155 Calle Portal
Ste 300
Sierra Vista, AZ 85635
Phone (520) 458-6331
251 W Rex Allen Dr
Willcox, AZ 85643
Interoperability endpoints
- nori.ruo.p1@direct.cchci.nextgenshare.com
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Douglas, AZ
- NPI 1942241443
-
- Federally Qualified Health Center (FQHC)
- Willcox, AZ
- NPI 1285488866
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425254400000",
"number": "1710922018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1205 F AVE",
"city": "DOUGLAS",
"state": "AZ",
"postal_code": "856071920",
"telephone_number": "520-364-1429",
"fax_number": "520-364-4261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "815 E 15TH ST",
"city": "DOUGLAS",
"state": "AZ",
"postal_code": "856071631",
"telephone_number": "520-364-5437",
"fax_number": "520-364-4261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUO",
"first_name": "NORI",
"middle_name": "Y",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2015-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "PA",
"license": "MD059349L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001606226",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Douglas, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.