Active NPI
Ellen Ruiz
- Pediatric Occupational Therapist
- Meridian, ID
National Provider Identifier
1891162145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT-1999
- Practice address
- 179 SW 5TH Ave
Meridian, ID 83642-2995 - Phone
- (208) 706-3699
- NPI assigned
- Aug 21, 2015
- 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 |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT-1999 | ID | Primary |
Addresses
Primary practice location
179 SW 5TH Ave
Meridian, ID 83642-2995
Mailing address
365 E Fairbrook Dr
Boise, ID 83706-5280
Phone (310) 567-8659
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 |
|---|---|---|---|
| OT-1999 | ID | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743379200000",
"number": "1891162145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "365 E FAIRBROOK DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837065280",
"telephone_number": "310-567-8659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "179 SW 5TH AVE",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836422995",
"telephone_number": "208-706-3699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUIZ",
"first_name": "ELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-21",
"last_updated": "2025-03-31",
"certification_date": "2025-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "ID",
"license": "OT-1999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.