Individual provider Active NPI

William Clinton Ruffian III, PA-C

  • Physician Assistant
  • Greenville, NC
National Provider Identifier
1952564882
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-01290 Issued in NC
Practice address
1510 E Arlington Blvd Ste B
Greenville, NC 27858-5348
Phone
(252) 375-3322
NPI assigned
Jul 10, 2008
Last updated
Oct 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-01290 NC Primary
Medical Physician Assistant 363AM0700X 0010-01290 NC

Addresses

Primary practice location

1510 E Arlington Blvd Ste B
Greenville, NC 27858-5348

Mailing address

1407 Cadenza CT
Greenville, NC 27858-6032
Phone (336) 906-0319

Other practice location 1

1240 Huffman Mill Rd
Emergency Dept
Burlington, NC 27215-8700
Phone (336) 538-7445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20080805000692 NC Practitioner - Physician Assistant 1850465188 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Down East IncGroup PAC ID 5395068332, 11 clinicians

Practice addresses (Care Compare)

505 Greenville Blvd SE
Greenville, NC 27858-6736
Phone (252) 623-2008

853 Washington Square Mall
Washington, NC 27889-3530
Phone (252) 623-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-01290NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Best Day Psychiatry and Counseling, PC Psychiatry CurrentSince Jul 16, 2020 Accepting new patients
Emergency Medicine Physicians of Lenoir County PLLC Past Accepting new patients

Locations

2587 Ravenhill Dr
Fayetteville, NC 28303
Phone (910) 323-1545

1510 E Arlington Blvd
Ste B
Greenville, NC 27858
Phone (252) 375-3322

Organizations & group practices 5

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1952564882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 CADENZA CT",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278586032",
            "telephone_number": "336-906-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 E ARLINGTON BLVD STE B",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585348",
            "telephone_number": "252-375-3322"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1240 Huffman Mill Rd",
            "address_2": "Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "NC",
            "postal_code": "272158700",
            "country_code": "US",
            "telephone_number": "336-538-7445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUFFIAN",
        "first_name": "WILLIAM",
        "middle_name": "CLINTON",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-01290",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-01290",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.