Individual provider Active NPI

John Allen Rulison, M.D.

  • Family Medicine Physician
  • Placerville, CA
National Provider Identifier
1952380446
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G061453 Issued in CA
Practice address
4327 Golden Center Dr
Placerville, CA 95667-6287
Phone
(530) 621-7704
Fax
(530) 621-7707
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G061453 CA Primary

Addresses

Primary practice location

4327 Golden Center Dr
Placerville, CA 95667-6287

Mailing address

4327 Golden Center Dr
Placerville, CA 95667-6287
Phone (530) 621-7704

Other identifiers 1

IdentifierTypeStateIssuer
00G614530MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060220000601 CA Practitioner - Family Practice 4880609338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G061453CAMDFamily Medicine Physician
G64153CAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: john.rulison@edchc.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231372800000",
    "number": "1952380446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4327 GOLDEN CENTER DR",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676287",
            "telephone_number": "530-621-7704",
            "fax_number": "530-621-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4327 GOLDEN CENTER DR",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676287",
            "telephone_number": "530-621-7704",
            "fax_number": "530-621-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RULISON",
        "first_name": "JOHN",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2009-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G061453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G614530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.