Benjamin L. Rucker M.D. P.C.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

017877 Issued in GA

Legal business name

BENJAMIN L. RUCKER M.D. P.C.

Practice address

1138 Druid Park Ave
Suite B
Augusta, GA 30904-5850

Phone

(706) 733-9447

Fax

(706) 738-0863

NPI assigned

May 29, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Beverly Michele Jackson

Title

Medical Assistant/ Office Manager

Phone

(706) 733-9447

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1033377882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 DRUID PARK AVE",
            "address_2": "SUITE B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045850",
            "telephone_number": "706-733-9447",
            "fax_number": "706-738-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 DRUID PARK AVE",
            "address_2": "SUITE B",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045850",
            "telephone_number": "706-733-9447",
            "fax_number": "706-738-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BENJAMIN L. RUCKER M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-29",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "MEDICAL ASSISTANT/ OFFICE MANAGER",
        "authorized_official_telephone_number": "706-733-9447",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "017877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G17877",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010270",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000153139-B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse Belyeu II
• Mohamed Ben Omran
• Jelani Dia Bender, MD
• Mireddy Benet-Rockefeller, DDS
• Cynthia Marie Benjamin Bates, APRN
• Kristen Heather Benjamin, APRN, BC
• Alanna Marie Bennett
• Barry Edward Bennett, D.M.D.
• Brian Nathan Bennett, D.P.M.
• Joseph Ronald Bennett, D.M.D.

• Internal Medicine Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.