Michigan Nutrigenetics

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

MICHIGAN NUTRIGENETICS

Practice address

6701 Boca Vista Dr NE Unit 102
Rockford, MI 49341-9655

Phone

(616) 255-5338

NPI assigned

Nov 3, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Dean Alan Ruble, DONPI 1922291137

Title

President

Phone

(616) 255-5338

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dean Alan Ruble, D.O.

  • Internal Medicine Physician
  • Warren, MI
  • NPI 1922291137
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1740997212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 BOCA VISTA DR NE UNIT 102",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419655",
            "telephone_number": "616-255-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 BOCA VISTA DR NE UNIT 102",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493419655",
            "telephone_number": "616-255-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN NUTRIGENETICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-03",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "RUBLE",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-255-5338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Craig Mette, D.D.S.
• Sarah Lynn Meyle, RN
• Michael J Kelley DPM
• Emily Michalak
• Michigan Medical Patient Care
• Steven Andrew Mikulak, D.C.
• Emily Grace Milan, OTR/L
• Jaiden Miles
• Jennifer Lynn Millard
• Blake Miller, DO

• Internal Medicine Physician in Rockford, MI
• Providers in Rockford, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.