Active NPI
Ruth-Anne Bollinger, NNP
- Nurse Practitioner
- Edgewood, KY
National Provider Identifier
1720161003
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3013289
- Practice address
- 1 Medical Village Dr
Edgewood, KY 41017 - Phone
- (859) 301-2423
- Fax
- (859) 301-2043
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 120839 | TN | |
| Nurse Practitioner | 363L00000X | 3013289 | KY | Primary |
Addresses
Primary practice location
1 Medical Village Dr
Edgewood, KY 41017
Mailing address
3333 Burnet Ave, ML 1013
Cincinnati, OH 45229-3026
Phone (513) 636-4466
Other practice location 1
1930 Alcoa Hwy
Suite 145
Knoxville, TN 37920-1500
Phone (865) 544-6650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12091 | Other | APN NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120839 | TN | MD | Neonatal Nurse Practitioner |
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": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564531200000",
"number": "1720161003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3333 BURNET AVE, ML 1013",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452293026",
"telephone_number": "513-636-4466",
"fax_number": "513-636-5846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL VILLAGE DR",
"city": "EDGEWOOD",
"state": "KY",
"postal_code": "41017",
"telephone_number": "859-301-2423",
"fax_number": "859-301-2043"
}
],
"practiceLocations": [
{
"address_1": "1930 Alcoa Hwy",
"address_2": "Suite 145",
"address_purpose": "LOCATION",
"city": "Knoxville",
"state": "TN",
"postal_code": "379201500",
"country_code": "US",
"telephone_number": "865-544-6650",
"fax_number": "865-544-6572",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOLLINGER",
"first_name": "RUTH-ANNE",
"credential": "NNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2019-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "TN",
"license": "120839",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3013289",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APN NUMBER",
"identifier": "12091",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Edgewood, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2019; 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.