Jarom Lucas Ruby, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

2851 Issued in NE

Practice address

238 Brookley Ave SW
Bolling Afb, DC 20032-7704

Phone

(202) 404-5865

NPI assigned

Mar 1, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1801542600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 BROOKLEY AVE SW",
            "city": "BOLLING AFB",
            "state": "DC",
            "postal_code": "200327704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 BROOKLEY AVE SW",
            "city": "BOLLING AFB",
            "state": "DC",
            "postal_code": "200327704",
            "telephone_number": "202-404-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBY",
        "first_name": "JAROM",
        "middle_name": "LUCAS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-01",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NE",
            "license": "2851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Allison Phelan, O.D.
• David G Ray, PHD
• Elizabeth Maria Reyna
• Darren P. Rhoton, O.D.
• Crystal Jeanette Rolon Aponte, PSYCHOLOGIST AND LPC
• Michelle Schuldt, NURSE PRACTITIONER
• Doan Singh
• Alan T Smith, DMD
• Chad Michael Smith, IDMT
• Diane Ruth Smith

• General Practice Physician in Bolling Afb, DC
• Providers in Bolling Afb, DC by specialty
• General Practice Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.