Individual provider Active NPI

Jeana Ruby

  • Licensed Practical Nurse
  • Flat Rock, MI
National Provider Identifier
1730577321
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703113895 Issued in MI
Practice address
26733 Emma Ave
Flat Rock, MI 48134-1664
Phone
(734) 858-8021
NPI assigned
Jan 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703113895 MI Primary

Addresses

Primary practice location

26733 Emma Ave
Flat Rock, MI 48134-1664

Mailing address

26733 Emma Ave
Flat Rock, MI 48134-1664
Phone (734) 858-8021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4703113895MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420416000000",
    "number": "1730577321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26733 EMMA AVE",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481341664",
            "telephone_number": "734-858-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26733 EMMA AVE",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481341664",
            "telephone_number": "734-858-8021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBY",
        "first_name": "JEANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-05",
        "last_updated": "2015-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703113895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flat Rock, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.