Individual provider Active NPI

Amber Ashlee Denham-Ruiz, MD

  • Pediatrics Physician
  • Baton Rouge, LA
National Provider Identifier
1881802007
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
201975 Issued in LA
Practice address
8415 Goodwood Blvd
Suite 100
Baton Rouge, LA 70806-7851
Phone
(225) 765-5633
Fax
(225) 765-5634
NPI assigned
May 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 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 201975 LA Primary

Addresses

Primary practice location

8415 Goodwood Blvd
Suite 100
Baton Rouge, LA 70806-7851

Mailing address

8415 Goodwood Blvd
Suite 100
Baton Rouge, LA 70806-7851
Phone (225) 765-5633

Other identifiers 1

IdentifierTypeStateIssuer
1174157MedicaidLA

Other names 1

  • Amber Ashlee Denham Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20100130000084 LA Practitioner - Pediatric Medicine 6709929755 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201975LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Pediatrics CurrentSince Jul 2, 2012 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Jul 2, 2012 Accepting new patients
Woman'S Hospital Foundation Past Accepting new patients
Our Lady of the Lake Hospital Inc Pediatrics Past Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

2051 Silverside Dr
Ste 260
Baton Rouge, LA 70808
Phone (225) 490-6301

8415 Goodwood Blvd
Ste 105
Baton Rouge, LA 70806
Phone (225) 765-4226

8415 Goodwood Blvd
Ste 100
Baton Rouge, LA 70806
Phone (225) 765-5633

18989 Old Scenic Hwy
Zachary, LA 70791
Phone (225) 654-6140

Interoperability endpoints

  • Direct secure messaging: adenham2660@direct.casso.us.com

Organizations & group practices 5

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": "1179619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1881802007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD",
            "address_2": "SUITE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-765-5633",
            "fax_number": "225-765-5634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8415 GOODWOOD BLVD",
            "address_2": "SUITE 100",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708067851",
            "telephone_number": "225-765-5633",
            "fax_number": "225-765-5634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENHAM-RUIZ",
        "first_name": "AMBER",
        "middle_name": "ASHLEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-20",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "201975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174157",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "DENHAM",
            "middle_name": "ASHLEE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.