CHARLES D. RUBLEY DBA BEAVERTON MEDICAL CLINIC (NPI# 1821504598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821504598 |
| Entity Type | Organization |
| Organization Name | CHARLES D. RUBLEY DBA BEAVERTON MEDICAL CLINIC |
| Other Organization Name | CHARLES D. RUBLEY DBA BEAVERTON MEDICAL CLINIC |
| Practice Address |
12815 Us Hwy 278 Beaverton AL 35544 |
| Mailing Address |
Po Box 38 Beaverton AL 35544-0038 |
| Practice Telephone | 2056061200 |
| Practice Fax Number | 2056061202 |
| Mailing Telephone | 2056061200 |
| Mailing Fax Number | 2056061202 |
| Enumeration Date | 2017-12-18 |
| Last Update Date | 2018-04-06 |
| Authorized Official Name | MR. CHARLES D RUBLEY (OWNER / PROVIDER) |
| Authorized Official Telephone | 2056061200 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-081378 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Charles D. Rubley dba Beaverton Medical Clinic | Doing Business As Name - Organization |
| Street Address |
12815 US HWY 278 |
| City | BEAVERTON |
| State | AL |
| Zip Code | 35544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113635 | Adam Hernandez | Chiropractor | 10208 Sw Conestoga Dr Apt 41, Beaverton, OR 97008-8416 | 2020-10-31 |
| 1730789439 | Carlin Chung | Dental Hygienist | 8839 Sw Amicus Ter, Beaverton, OR 97007-9045 | 2020-10-30 |
| 1700486438 | Jane Jeeyoon Kim | Dentist | 14425 Sw Allen Blvd # 1, Beaverton, OR 97005-4402 | 2020-10-30 |
| 1124628417 | Biohax | Nurse Practitioner | 17933 Nw Evergreen Pkwy Ste 285, Beaverton, OR 97006-7661 | 2020-10-27 |
| 1366041071 | Christina Cabelly | Family Medicine | 16305 Sw Loon Dr, Beaverton, OR 97007-8989 | 2020-10-23 |
| 1184223356 | Sarah Miller | Pharmacy Technician | 8300 Sw Creekside Pl, Beaverton, OR 97008-8178 | 2020-10-20 |
| 1881292639 | Blueprint Sports Therapy | Clinic/Center | 17440 Sw Reusser Ct, Beaverton, OR 97007-8772 | 2020-10-14 |
| 1730787615 | Michael Hisao Mun Ho Pang | Physician Assistant | 1245 Sw 160th Ave, Beaverton, OR 97006-5052 | 2020-10-13 |
| 1043817802 | Northwest Medical LLC | Durable Medical Equipment & Medical Supplies | 17933 Nw Evergreen Pl Ste 270, Beaverton, OR 97006-7532 | 2020-10-05 |
| 1053918193 | Evan Chin | Chiropractor | 3615 Sw Hall Blvd, Beaverton, OR 97005-2053 | 2020-10-01 |
| Find all providers in BEAVERTON | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619083870 | Elyn M Lewis | Nurse Practitioner | 12270 Sw 1st St, Suite 200, Beaverton, OR 97005-2848 | 2006-08-21 |
| 1902835275 | Emilia Christina Bazan-grow | Nurse Practitioner | 13235 Sw Glenhaven St, Beaverton, OR 97005-0958 | 2006-06-30 |
| 1982682035 | Karen Ann Riesinger | Nurse Practitioner | 17175 Sw Tualatin Valley Hwy Ste A, Beaverton, OR 97003-4584 | 2006-01-07 |
| 1235136615 | Deborah A. Loewer | Nurse Practitioner | 4510 Sw Hall Blvd, Beaverton, OR 97005-0504 | 2005-06-30 |
| 1508316878 | Karletia Lewis | Nurse Practitioner | 14795 Sw Murray Scholls Dr Ste 121, Beaverton, OR 97007-9713 | 2016-10-10 |
| 1104271600 | Kathryn Marie Lund | Nurse Practitioner | 12345 Sw Horizon Blvd Ste 57, Beaverton, OR 97007-9475 | 2016-05-03 |
| 1275936445 | Susan M Knoerr | Nurse Practitioner | 439 S Ross St, Beaverton, MI 48612-9101 | 2014-10-02 |
| 1831517507 | Trisha Haskins | Nurse Practitioner | 15950 Sw Millikan Way, Beaverton, OR 97003-5170 | 2014-03-31 |
| 1538583471 | Joana Silva | Nurse Practitioner | 2935 Sw Cedar Hills Blvd, Beaverton, OR 97005-1342 | 2014-02-12 |
| 1225314792 | Lydia C Warner | Nurse Practitioner | 1500 Nw Bethany Blvd Ste 200, Beaverton, OR 97006-5236 | 2011-10-28 |
| Find all providers in BEAVERTON | ||||
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| 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.