Shanna Rucker, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017042 Issued in CA

Practice address

2707 S Central Ave
Los Angeles, CA 90011-5527

Phone

(702) 612-6316

NPI assigned

Apr 26, 2021

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 CA

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

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Woundologie Nursing PC

  • Family Nurse Practitioner
  • Lancaster, CA
  • NPI 1700755063
  Medicare reassignment NPD Authorized official
• Amniotti Inc

  • Multi-Specialty Clinic/Center
  • Beverly Hills, CA
  • NPI 1780465062
  Medicare reassignment NPD
• Feldmar Medical Corporation

  • Plastic Surgery Physician
  • Beverly Hills, CA
  • NPI 1669773859
  Medicare reassignment NPD
• Wound Resource Professional Corporation

  • Family Nurse Practitioner
  • Lancaster, CA
  • NPI 1164396602
  NPD Authorized official
• Global Wound Care Medical Group

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1235831132
  NPD

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1194307421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8416 DELCO AVE",
            "city": "WINNETKA",
            "state": "CA",
            "postal_code": "913061317",
            "telephone_number": "702-612-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900115527",
            "telephone_number": "702-612-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "SHANNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianna Rucker
• Denell Rucker
• Jessica Rucker
• Latoya Rucker
• Ronald G. Rucker, PHARM. D.
• Leonard Ruckman
• Rachel Anne Elizabeth Rud, LMFT, MS
• Dale A Rudd, ATC
• Darryl Rudd
• Nolan Rudd

• Family Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; 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.
• 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.