Individual provider Active NPI

Ernesto Ruiz Valdes

  • Gerontology Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1912705328
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AG02250101 Issued in KY
Practice address
6608 Lincoln Ridge PL Apt 201
Louisville, KY 40228-2596
Phone
(502) 678-8956
NPI assigned
Mar 4, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AG02250101 KY Primary
Adult Health Nurse Practitioner 363LA2200X AG02250101 KY

Addresses

Primary practice location

6608 Lincoln Ridge PL Apt 201
Louisville, KY 40228-2596

Mailing address

6608 Lincoln Ridge PL Apt 201
Louisville, KY 40228-2596
Phone (502) 678-8956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20251124003858 KY Practitioner - Nurse Practitioner 0840782140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Park Duvalle Community Health Center, IncGroup PAC ID 1658268974, shared by 8 NPIs, 22 clinicians

Practice addresses (Care Compare)

3015 Wilson Ave
Louisville, KY 40211-1969
Phone 50277444011509

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG02250101KYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Health Network LLC CurrentSince Nov 1, 2025 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

Interoperability endpoints

  • Direct secure messaging: ernesto.ruiz-valdes.1@27238.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": "1741046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1912705328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6608 LINCOLN RIDGE PL APT 201",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402282596",
            "telephone_number": "502-678-8956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6608 LINCOLN RIDGE PL APT 201",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402282596",
            "telephone_number": "502-678-8956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUIZ VALDES",
        "first_name": "ERNESTO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-04",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "KY",
            "license": "AG02250101",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "AG02250101",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.