Tanaka Ruzvidzo, APRN-CNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1179783 Issued in TX

Practice address

3023 Perryton Pkwy
Pampa, TX 79065-2821

Phone

(806) 665-0801

Fax

(806) 665-8503

NPI assigned

Nov 13, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• SPMG Signature Pampa Medical Group

  • Family Medicine Physician
  • Pampa, TX
  • NPI 1770716896

  TX

  Medicare reassignment NPD
• SPMG Signature Pampa Medical Group

  • Anesthesiology Physician
  • Pampa, TX
  • NPI 1295075976
  NPD

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1124842398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 PERRYTON PKWY",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790652821",
            "telephone_number": "806-665-0801",
            "fax_number": "806-665-8503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 PERRYTON PKWY",
            "city": "PAMPA",
            "state": "TX",
            "postal_code": "790652821",
            "telephone_number": "806-665-0801",
            "fax_number": "806-665-8503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUZVIDZO",
        "first_name": "TANAKA",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1179783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kellie Michele Roby, AGPCNP-BC
• Roden Investments Inc
• Jodi B Roden, PT
• Maria Rodriguez
• Robin Elizabeth Rothrock, MD
• Nathin Leroy Seals, PA, PHARMD
• Tiffany Dawn Shadle, FNP-C
• Kamalpreet Shallu
• Shepards Crook Nursing Agency, Inc.
• Kevin D Sieck, MD

• Psychiatric/Mental Health Nurse Practitioner in Pampa, TX
• Providers in Pampa, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.