Douglas F Ruzicka, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

269000 Issued in NE

Practice address

825 22ND St
Fairbury, NE 68352-1221

Phone

(402) 729-3361

NPI assigned

Jan 28, 2006

Last updated

Apr 24, 2008By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1138406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208995200000",
    "number": "1932170966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 22ND ST",
            "city": "FAIRBURY",
            "state": "NE",
            "postal_code": "683521221",
            "telephone_number": "402-729-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 22ND ST",
            "city": "FAIRBURY",
            "state": "NE",
            "postal_code": "683521221",
            "telephone_number": "402-729-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZICKA",
        "first_name": "DOUGLAS",
        "middle_name": "F",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-28",
        "last_updated": "2008-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NE",
            "license": "269000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regenia Putman, LPN
• Brenda S Rippe, BS ED
• Sarah A Roesler, M.S., CCC-SLP
• Marla M Root, LMHP/CPC
• Dennis L. Russell, R.P.
• Danielle Marie Schelbitzki
• Becki Renae Schmidt
• Jade Schmit, RN
• Catherine J Schroeder, M.S. CCC-SLP
• Kayla Renee Specht, PHARMD

• Medical Physician Assistant in Fairbury, NE
• Providers in Fairbury, NE by specialty
• Medical Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.