Active NPI
Ruthie Su, MD
- Pediatric Urology Physician
- Little Rock, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Urology Physician
- License
- E17173
- Practice address
- 1 Childrens Way
Little Rock, AR 72202-3500 - Phone
- (501) 364-2090
- Fax
- (501) 364-3929
- NPI assigned
- Apr 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 60839 | WI | |
| Pediatric Urology Physician | 2088P0231X | 60839 | WI | |
| Pediatric Urology Physician | 2088P0231X | E17173 | AR | Primary |
Addresses
Primary practice location
1 Childrens Way
Little Rock, AR 72202-3500
Mailing address
1 Childrens Way # 844
Little Rock, AR 72202-3500
Phone (501) 364-2090
Other practice location 1
137 E Wilson St Unit 710
Madison, WI 53703-4080
Phone (559) 360-5666
Other practice location 2
2601 Gene George Blvd
Springdale, AR 72762-0845
Phone (501) 364-2090
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201200200A | Medicaid | OK | |
| 200132676 | Medicaid | MO | |
| 311524001 | Medicaid | AR |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rsu681212@direct.uwhealth.org | ||
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | rsu169792@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60839 | WI | MD | Urology Physician |
| E17173 | AR | MD | Pediatric Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Children's Medical Group PLLC | Current | Accepting new patients | |
| Aurora Medical Group, Inc. | Current | Accepting new patients | |
| Arkansas Childrens Hospital | Past | Accepting new patients |
Locations
1 Childrens Way
Little Rock, AR 72202
Phone (501) 364-1874
1 Childrens Way
#844
Little Rock, AR 72202
Phone (501) 364-2090
900 S 52nd St
Rogers, AR 72758
Phone (501) 364-2090
2601 Gene George Blvd
Springdale, AR 72762
Phone (479) 725-6800
1160 Kepler Dr
Green Bay, WI 54311
Phone (920) 288-5400
1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056
855 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 451-5643
Interoperability endpoints
- rsu681212@direct.uwhealth.org
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 and National Provider Directory roles.
-
- Pediatrics Physician
- Little Rock, AR
- NPI 1396274841
-
- Certified Registered Nurse Anesthetist
- Milwaukee, WI
- NPI 1427271378
-
- Dental Clinic/Center
- Little Rock, AR
- NPI 1770889552
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732233600000",
"number": "1952544793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CHILDRENS WAY # 844",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023500",
"telephone_number": "501-364-2090",
"fax_number": "501-364-3929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CHILDRENS WAY",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722023500",
"telephone_number": "501-364-2090",
"fax_number": "501-364-3929"
}
],
"practiceLocations": [
{
"address_1": "137 E Wilson St Unit 710",
"address_purpose": "LOCATION",
"city": "Madison",
"state": "WI",
"postal_code": "537034080",
"country_code": "US",
"telephone_number": "559-360-5666",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2601 Gene George Blvd",
"address_purpose": "LOCATION",
"city": "Springdale",
"state": "AR",
"postal_code": "727620845",
"country_code": "US",
"telephone_number": "501-364-2090",
"fax_number": "501-364-3929",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SU",
"first_name": "RUTHIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-09",
"last_updated": "2024-11-22",
"certification_date": "2024-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WI",
"license": "60839",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "WI",
"license": "60839",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "AR",
"license": "E17173",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201200200A",
"state": "OK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200132676",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "311524001",
"state": "AR"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rsu681212@direct.uwhealth.org",
"affiliation": "N",
"address_1": "1675 Highland Ave",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537920002",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1675 Highland Ave",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537920002",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rsu169792@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1675 Highland Ave",
"city": "Madison",
"state": "WI",
"country_code": "US",
"postal_code": "537920002",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.