Individual provider Active NPI

Ruth Alison Loomis, MD

  • Pediatrics Physician
  • Bristol, CT
National Provider Identifier
1780668012
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
043208 Issued in CT
Practice address
43 Enterprise Dr
Bristol, CT 06010-7457
Phone
(860) 589-5230
Fax
(860) 589-5297
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 043208 CT Primary

Addresses

Primary practice location

43 Enterprise Dr
Bristol, CT 06010-7457

Mailing address

43 Enterprise Dr
Bristol, CT 06010-7457
Phone (860) 589-5230

Other identifiers 1

IdentifierTypeStateIssuer
001432088MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20050909000045 CT Practitioner - Pediatric Medicine 7315979457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Connecticut School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

240 Stafford Ave
Bristol, CT 06010-4688
Phone (860) 584-7682

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043208CTMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bristol-Burlington Health District CurrentSince Mar 31, 2025 Accepting new patients

Locations

240 Stafford Ave
Bristol, CT 06010
Phone (860) 584-7682

Interoperability endpoints

  • Direct secure messaging: ruth.loomis.1@22544.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1780668012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 ENTERPRISE DR",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060107457",
            "telephone_number": "860-589-5230",
            "fax_number": "860-589-5297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 ENTERPRISE DR",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060107457",
            "telephone_number": "860-589-5230",
            "fax_number": "860-589-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOMIS",
        "first_name": "RUTH",
        "middle_name": "ALISON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "043208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001432088",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.