Individual provider Active NPI

Joshua Kyle Rucker, D.C.

  • Chiropractor
  • Knoxville, TN
National Provider Identifier
1043612369
Registry record updated Feb 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2792 Issued in TN
Practice address
5908 Toole Dr Ste E
Knoxville, TN 37919-4172
Phone
(865) 444-5994
NPI assigned
Sep 17, 2014
Last updated
Feb 15, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2792 TN Primary

Addresses

Primary practice location

5908 Toole Dr Ste E
Knoxville, TN 37919-4172

Mailing address

5908 Toole Dr Ste E
Knoxville, TN 37919-4172
Phone (865) 444-5994

Other practice location 1

1148 Gallatin Pike S
Madison, TN 37115-4611
Phone (800) 961-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211116000130 TN Practitioner - Chiropractic 6204225246 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5908 Toole Dr
Suite Ef
Knoxville, TN 37919-4124
Phone (865) 444-5994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2792TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Top Chiropractic LLC Chiropractor CurrentSince Oct 8, 2021 Accepting new patients

Locations

5908 Toole Dr
Ste Ef
Knoxville, TN 37919
Phone (865) 444-5994

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1410912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1043612369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 TOOLE DR STE E",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194172",
            "telephone_number": "865-444-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5908 TOOLE DR STE E",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194172",
            "telephone_number": "865-444-5994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1148 Gallatin Pike S",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "TN",
            "postal_code": "371154611",
            "country_code": "US",
            "telephone_number": "800-961-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "JOSHUA",
        "middle_name": "KYLE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-17",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.