Jon Leslie Ruckle, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

00024572 Issued in WA

Practice address

1402 S Brookside Ter
Tacoma, WA 98465-1210

Phone

(253) 448-8690

NPI assigned

Mar 5, 2008

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1204675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378339200000",
    "number": "1124298161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 S BROOKSIDE TER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651210",
            "telephone_number": "253-448-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S BROOKSIDE TER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651210",
            "telephone_number": "253-448-8690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKLE",
        "first_name": "JON",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-05",
        "last_updated": "2013-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "MD-11129",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "00024572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jurea Rubit
• Tim Earl Rubottom I, ATC
• Denise Ruby, RN
• Kayla Ruby, EAMP
• Michelle Lynn Rucker
• Amanda Starr Rudisill, AAC, CPC
• Rachel Renee Rudnick
• Jenna Lynn Rudnitskas
• Marissa Rudolph, PH.D.
• Florida J Rue, RNFA

• Internal Medicine Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2013; 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.