Organization Active NPI

Dr. Rubys Haven Blends and Bubbles

  • Nurse Practitioner
  • Antlers, OK
National Provider Identifier
1992650923
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
DR. RUBYS HAVEN BLENDS AND BUBBLES
Practice address
107 SE 2ND St
Antlers, OK 74523-4018
Phone
(580) 209-6111
Fax
(580) 982-5482
NPI assigned
Mar 4, 2026
Last updated
Apr 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Authorized official

Name
Ruby Runee Pate, DNPNPI 1609399450
Title
Ceo, DNP
Phone
(580) 209-6111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU Primary

Addresses

Primary practice location

107 SE 2ND St
Antlers, OK 74523-4018

Mailing address

107 SE 2ND St
Antlers, OK 74523-4018
Phone (580) 209-6111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260423002602 OK Part B Supplier - Clinic/Group Practice 3476020793 Receives reassigned benefits from 1 practitioner
Practice locations: Antlers, OK

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1772582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776211200000",
    "number": "1992650923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SE 2ND ST",
            "city": "ANTLERS",
            "state": "OK",
            "postal_code": "745234018",
            "telephone_number": "580-209-6111",
            "fax_number": "580-982-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SE 2ND ST",
            "city": "ANTLERS",
            "state": "OK",
            "postal_code": "745234018",
            "telephone_number": "580-209-6111",
            "fax_number": "580-982-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RUBYS HAVEN BLENDS AND BUBBLES",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-04",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A",
        "authorized_official_last_name": "PATE",
        "authorized_official_first_name": "RUBY",
        "authorized_official_middle_name": "RUNEE",
        "authorized_official_title_or_position": "CEO, DNP",
        "authorized_official_telephone_number": "580-209-6111",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antlers, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.