Individual provider Active NPI

Andrea P Ruble, RN, FNP-BC

  • Family Nurse Practitioner
  • Sierra Vista, AZ
National Provider Identifier
1902050057
Registry record updated Aug 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN111510 Issued in AZ
Practice address
5750 E Highway 90
Sierra Vista, AZ 85635-9111
Phone
(520) 263-2000
NPI assigned
Nov 14, 2008
Last updated
Aug 23, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN111510 AZ Primary

Addresses

Primary practice location

5750 E Highway 90
Sierra Vista, AZ 85635-9111

Mailing address

PO Box 2186
Sierra Vista, AZ 85636-2186
Phone (520) 439-0115

Other practice location 1

3003 N Central Ave
Phoenix, AZ 85012-2902
Phone (602) 253-0373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110819000173 AZ Practitioner - Nurse Practitioner 3274675368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sierra Vista Regional Health Center Medical Group LLCGroup PAC ID 3779732854, 45 clinicians

Practice addresses (Care Compare)

5700 E Hwy 90
FL 4
Sierra Vista, AZ 85635-9110
Phone (520) 417-3835

5750 E Hwy 90
Suite 200
Sierra Vista, AZ 85635-9113
Phone (520) 263-3500

7 N San Diego St
Tombstone, AZ 85638-0406
Phone (520) 457-2374

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN111510AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sierra Vista Regional Health Center Medical Group LLC CurrentSince Sep 1, 2019 Accepting new patients

Locations

5700 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

5750 E Highway 90
Sierra Vista, AZ 85635
Phone (520) 263-2000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1226620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1902050057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2186",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856362186",
            "telephone_number": "520-439-0115",
            "fax_number": "520-458-3016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750 E HIGHWAY 90",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856359111",
            "telephone_number": "520-263-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3003 N Central Ave",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850122902",
            "country_code": "US",
            "telephone_number": "602-253-0373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUBLE",
        "first_name": "ANDREA",
        "middle_name": "P",
        "credential": "RN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-14",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN111510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sierra Vista, AZ

Sources for this page

Verify at the official NPI Registry.