Pearl Rose Rucker

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AC004015 Issued in MD

Practice address

9309 Belair Rd Ste D
Baltimore, MD 21236-1605

Phone

(410) 505-7952

Fax

(410) 701-3845

NPI assigned

Apr 2, 2021

Last updated

Dec 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Brilliance Psychiatry and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Towson, MD
  • NPI 1386351815
  NPD Authorized official
• Optimal Psychiatry and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Nottingham, MD
  • NPI 1295379121
  NPD (past)

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638316800000",
    "number": "1003495557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7652 BELAIR RD STE A",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364067",
            "telephone_number": "410-927-3510",
            "fax_number": "410-656-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9309 BELAIR RD STE D",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212361605",
            "telephone_number": "410-505-7952",
            "fax_number": "410-701-3845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "PEARL",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN230900",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "AC004015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irina Gregory Rubo, LCSW-C
• Sara Rubovits, CGC
• Ken Ruby III, LCSW
• Narong Ruchira, MD
• Jessica Moore Ruck, MD
• Susan Rucker, L.C.S.W.-C.
• Theresa J Ruddy, C.P.N.P., CRNP
• Amy Rudich, LCSW
• Scott Rudick, D.C.
• Sara Elizabeth Rudiger, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.