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Deactivated NPI 1437465614 Deactivated / Inactive NPI Male Practitioner

Jay Hanson Wruck , COMA, CPP

Technician/Technologist • Kennesaw, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jay Wruck has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 25, 2010
NPI Deactivation Date March 13, 2024
Total Practice Duration ~14 Years of Practice (2010 – 2024)

Professional Overview & Biography Verified Profile Summary

Jay Wruck, COMA, CPP was a registered Technician/Technologist practicing in Kennesaw, GA. Throughout an active medical career spanning 14 years, Jay Wruck provided care at the practice location at 4318 EDGEWATER DR NW until profile deactivation on 2024-03-13.

Practice Location & Contact Primary Location

Practice Address

4318 Edgewater Dr Nw

Kennesaw, GA 301445170

Telephone 7705921580

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician/Technologist in Kennesaw, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Kennesaw, GA (72 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Technician/Technologist Primary Specialty

NUCC Taxonomy Code: 156F00000X

State License GA 2010#65900

A broad category grouping different kinds of technologists and technicians. See individual definitions.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 13, 2024

Record deactivated on March 13, 2024

NPI Profile Active August 25, 2010

NPI status registered as active in NPPES database

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Updated Practice Location August 25, 2010

Registered at 4318 EDGEWATER DR NW, KENNESAW, GA 301445170 (Tel: 7705921580)

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Updated Business Mailing Address August 25, 2010

Registered at 4318 EDGEWATER DR NW, KENNESAW, GA 301445170 (Tel: 7705921580)

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Provider Name / Credentials Updated August 25, 2010

Recorded as JAY WRUCK, C.O.M.A./C.P.P.

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 25, 2010

Technician/Technologist (License #2010#65900 in GA)

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Initial NPI Registration & Enumeration August 25, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1437465614
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 25, 2010
Last Update: August 25, 2010
Deactivation Date: March 13, 2024

Mailing Address

4318 Edgewater Dr Nw

Kennesaw, GA 301445170

Phone: 7705921580

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.