DR. LAURIE FAIRALL-RUETER, LLC (NPI# 1669795761) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669795761 |
| Entity Type | Organization |
| Organization Name | DR. LAURIE FAIRALL-RUETER, LLC |
| Other Organization Name | LAURIE FAIRALL-RUETER |
| Practice Address |
4400 Marsh Landing Blvd Suite 1 Ponte Vedra Beach FL 32082-1287 |
| Practice Telephone | 9044632284 |
| Practice Fax Number | 9045437755 |
| Mailing Telephone | 9044632284 |
| Mailing Fax Number | 9045437755 |
| Enumeration Date | 2010-03-04 |
| Last Update Date | 2014-04-17 |
| Authorized Official Name | DR. LAURIE FAIRALL-RUETER (LICENSED PSYCHOLOGIST) |
| Authorized Official Telephone | 9044632284 |
| Authorized Official Credential | PSY.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
36593 | TX | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PY003739 | GA | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY 7675 | FL | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Laurie Fairall-Rueter | Other Name - Individual/Organization |
| Street Address |
4400 MARSH LANDING BLVD SUITE 1 |
| City | PONTE VEDRA BEACH |
| State | FL |
| Zip Code | 32082-1287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922052257 | David Meriwether Harvey | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-7215 | 2006-05-20 |
| 1083088165 | Dr Fairall and Associates Behavioral Health and Family Mediation Servi | Psychologist | 4400 Marsh Landing Blvd, Suite 1, Ponte Vedra Beach, FL 32082-7215 | 2015-11-30 |
| 1174783161 | David M Harvey Phd P A | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-7215 | 2008-06-12 |
| 1265539555 | Jane Young Hill | Social Worker | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-1287 | 2006-09-20 |
| 1336250083 | James November | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-1287 | 2006-08-31 |
| 1487768248 | Laurie S. Fairall-rueter | Psychologist | 4400 Marsh Landing Blvd, Suite 1, Ponte Vedra Beach, FL 32082-1287 | 2006-08-18 |
| 1912989658 | Joan Simon | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-7215 | 2005-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576818 | Specialty Eye Surgeons, Pa | Ophthalmology | 240 Ponte Vedra Boulevard, Suite 202, Ponte Vedra Beach, FL 32082 | 2020-07-23 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1568988129 | Mustafa Bakir | General Practice | 1102 A1a, Ponte Vedra Beach, FL 32082 | 2017-08-16 |
| 1457890584 | Angelyn Sorgen | Nurse Practitioner | 1102 Hwy A1a, Suite 104, Ponte Vedra Beach, FL 32082 | 2017-02-22 |
| 1033575121 | Balanced Physician Care Pa | Family Medicine | 115 Professional Park Drive, Suite 104, Ponte Vedra Beach, FL 32082 | 2016-01-06 |
| 1528436060 | Robert Thompson II | Chiropractor | 135 Professional Drive, Suite 105, Ponte Vedra Beach, FL 32082 | 2015-09-14 |
| 1144628439 | Integrative Medical Group, Usa, LLC | Clinic/Center | 1102 A1a North, Suite 104, Ponte Vedra Beach, FL 32082 | 2014-12-18 |
| 1811308901 | Janice Wachtel, Phd, LLC | Psychologist | 100 Executive Way, Suite 110, Ponte Vedra Beach, FL 32082 | 2014-05-12 |
| 1578991154 | Nicole Theiler | Counselor | 171 Canal Blvd, Ponte Vedra Beach, FL 32082 | 2013-10-17 |
| 1982948006 | Daisamma Varghese | Nurse Practitioner | 860 A1an, Ponte Vedra, FL 32082 | 2012-11-15 |
| Find all providers in zip 32082 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811308901 | Janice Wachtel, Phd, LLC | Psychologist | 100 Executive Way, Suite 110, Ponte Vedra Beach, FL 32082 | 2014-05-12 |
| 1083764039 | Bambi Lynn Wadelton | Psychologist | 13000 Sawgrass Village Cir, Suite 46, Ponte Vedra Beach, FL 32082-5016 | 2007-01-11 |
| 1144338211 | David Blackmon | Psychologist | 330 A1a N Ste 325, Ponte Vedra Beach, FL 32082-1826 | 2006-08-28 |
| 1922052257 | David Meriwether Harvey | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-7215 | 2006-05-20 |
| 1710969423 | Robi E Tamargo | Psychologist | 115 Solana Rd Ste 115, Ponte Vedra Beach, FL 32082-5230 | 2005-11-17 |
| 1447651575 | Keri Franklin | Psychologist | 171 Canal Blvd, Ponte Vedra Beach, FL 32082-3607 | 2014-09-08 |
| 1922348416 | Ponte Vedra Psychologists, LLC | Psychologist | 2304 Sawgrass Village Dr, Ponte Vedra Beach, FL 32082-5007 | 2013-02-21 |
| 1184996704 | Naomi T. Jacobs, Ph.d., P.a. | Psychologist | 100 Executive Way, Suite 207, Ponte Vedra Beach, FL 32082-2715 | 2012-01-27 |
| 1174783161 | David M Harvey Phd P A | Psychologist | 4400 Marsh Landing Blvd, Suite 6, Ponte Vedra Beach, FL 32082-7215 | 2008-06-12 |
| 1275641110 | Naomi Jacobs | Psychologist | 100 Executive Way, Suite 207, Ponte Vedra Beach, FL 32082-2715 | 2006-08-29 |
| Find all providers in PONTE VEDRA BEACH | ||||
| City | PONTE VEDRA BEACH |
| Zip Code | 32082 |
Please comment or provide details below to improve the information on DR. LAURIE FAIRALL-RUETER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.