Individual provider Active NPI

Steven Ruiz

  • Internal Medicine Physician
  • Johnson City, TN
National Provider Identifier
1780098566
Registry record updated Nov 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO3606 Issued in TN
Practice address
325 N State of Franklin Rd FL 2
Johnson City, TN 37604-6092
Phone
(423) 439-7280
Fax
(423) 439-7314
NPI assigned
Jun 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO3606 TN Primary
Internal Medicine Physician 207R00000X 25MB10162400 NJ
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

325 N State of Franklin Rd FL 2
Johnson City, TN 37604-6092

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 433-6039

Other practice location 1

1505 W Sherman Ave
Vineland, NJ 08360-6912
Phone (856) 641-7675

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190208002040 TN Practitioner - Internal Medicine 8325314693 Reassigns benefits to 2 organizations
I20250415003316 GA Practitioner - Internal Medicine 8325314693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Edward Via Col of Osteo Medicine-Virginia Campus, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1700 Medical Way
Snellville, GA 30078-2195
Phone (770) 736-2283

Hospital & facility affiliations

  • Piedmont Eastside Medical Center Hospital, Snellville, GA, CCN 110192
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO3606TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation Internal Medicine CurrentSince Nov 26, 2018 Accepting new patients
Hospital Physician Services - Southeast Professional Corporation CurrentSince Apr 1, 2025 Accepting new patients
Eastside Medical Center, LLC Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

501 Redmond Rd NW
Rome, GA 30165
Phone (706) 291-0291

1700 Medical Way
Snellville, GA 30078
Phone (770) 978-4229

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

325 N State of Franklin Rd
Fl 2
Johnson City, TN 37604
Phone (423) 439-7280

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542672000000",
    "number": "1780098566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-433-6039",
            "fax_number": "423-433-6060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 N STATE OF FRANKLIN RD FL 2",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046092",
            "telephone_number": "423-439-7280",
            "fax_number": "423-439-7314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 W Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083606912",
            "country_code": "US",
            "telephone_number": "856-641-7675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUIZ",
        "first_name": "STEVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2018-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "DO3606",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MB10162400",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.