Active NPI
Maryruth Elizabeth Murray
- Counselor
- Yulee, FL
National Provider Identifier
1770737397
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- MH10118
- Practice address
- 463142 State Road 200
Yulee, FL 32097-5554 - Phone
- (904) 225-8280
- Fax
- (904) 225-8832
- NPI assigned
- Nov 10, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | MH10118 | FL | Primary |
Addresses
Primary practice location
463142 State Road 200
Yulee, FL 32097-5554
Mailing address
463142 State Road 200
Yulee, FL 32097-5554
Phone (904) 225-8280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001644500 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| MH10118 | FL | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1226275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1293580800000",
"number": "1770737397",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "463142 STATE ROAD 200",
"city": "YULEE",
"state": "FL",
"postal_code": "320975554",
"telephone_number": "904-225-8280",
"fax_number": "904-225-8832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "463142 STATE ROAD 200",
"city": "YULEE",
"state": "FL",
"postal_code": "320975554",
"telephone_number": "904-225-8280",
"fax_number": "904-225-8832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURRAY",
"first_name": "MARYRUTH",
"middle_name": "ELIZABETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-10",
"last_updated": "2010-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "MH10118",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001644500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yulee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.