Individual provider Active NPI

Edward Wood Ruffin, LCSW

  • Clinical Social Worker
  • Macon, GA
National Provider Identifier
1942397203
Registry record updated May 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001481 Issued in GA
Practice address
175 Emery Highway
Macon, GA 31217
Phone
(478) 803-7631
Fax
(478) 751-4530
NPI assigned
Oct 6, 2006
Last updated
May 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 001481 GA Primary

Addresses

Primary practice location

175 Emery Highway
Macon, GA 31217

Mailing address

175 Emery Highway
Macon, GA 31217
Phone (478) 803-7631

Other identifiers 1

IdentifierTypeStateIssuer
001481OtherGALCSW

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
001481GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Behavioral Care of Central Ga, PC Past Accepting new patients
Senior Psych Solutions Corp Clinical Past Accepting new patients
Georgia Orthotics & Prosthetics Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337299200000",
    "number": "1942397203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EMERY HIGHWAY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-803-7631",
            "fax_number": "478-751-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 EMERY HIGHWAY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "31217",
            "telephone_number": "478-803-7631",
            "fax_number": "478-751-4530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFIN",
        "first_name": "EDWARD",
        "middle_name": "WOOD",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2012-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "001481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "001481",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.