Shannon Alexander Ruth, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA05863 Issued in TX

Practice address

130 Hays St
Suite D
Luling, TX 78648-3207

Phone

(830) 875-3445

Fax

(830) 875-3765

NPI assigned

Mar 27, 2008

Last updated

Nov 8, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Ascension Seton

  dba SEBD Professional Support Services

  • Family Medicine Physician
  • Luling, TX
  • NPI 1215118609
  NPD (past)
• Tri-County Clinical

  • Family Medicine Physician
  • Luling, TX
  • NPI 1336456227
  NPD (past)

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1720250087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HAYS ST",
            "address_2": "SUITE D",
            "city": "LULING",
            "state": "TX",
            "postal_code": "786483207",
            "telephone_number": "830-875-3445",
            "fax_number": "830-875-3765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HAYS ST",
            "address_2": "SUITE D",
            "city": "LULING",
            "state": "TX",
            "postal_code": "786483207",
            "telephone_number": "830-875-3445",
            "fax_number": "830-875-3765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUTH",
        "first_name": "SHANNON",
        "middle_name": "ALEXANDER",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-27",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA05863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280084902",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Post Acute Medical at Luling LLC (Warm Springs Specialty Hospital at Luling)
• Post Acute Medical at Luling, LLC (Warm Springs Specialty Hospital of Luling)
• Honeybee E, Powell, N.P.
• Provider Healthcare Services of Luling, LLC (OakCreek Nursing & Rehab)
• Provider Healthcare Services of Luling, LLC (Oakcreek Nursing and Rehabilitation)
• Salveo Health Care Central Texas PLLC
• Sarah Lester PLLC
• Seton Family of Hospitals
• Seton Family of Hospitals (Luling CRNA Group)
• Seton Family of Hospitals

• Medical Physician Assistant in Luling, TX
• Providers in Luling, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; 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.