Individual provider Active NPI

Debora Ruckes Curtis

  • Psychiatric/Mental Health Nurse Practitioner
  • Southfield, MI
National Provider Identifier
1235674870
Registry record updated Jan 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704187285 Issued in MI
Practice address
16250 Northland Dr Ste 200a
Southfield, MI 48075-5227
Phone
(313) 415-7240
NPI assigned
Jan 5, 2017
Last updated
Jan 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704187285 MI Primary
General Practice Registered Nurse 163WG0000X 4704187285 MI

Addresses

Primary practice location

16250 Northland Dr Ste 200a
Southfield, MI 48075-5227

Mailing address

18932 Pennington Dr
Detroit, MI 48221-2168
Phone (313) 415-7240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210326002204 MI Practitioner - Nurse Practitioner 5890711998 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704187285MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RTS Practitioner Staffing Service LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

21701 W 11 Mile Rd
Ste 5
Southfield, MI 48076
Phone (248) 595-5958

Organizations & group practices 2

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": "1483574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1235674870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18932 PENNINGTON DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212168",
            "telephone_number": "313-415-7240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 NORTHLAND DR STE 200A",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755227",
            "telephone_number": "313-415-7240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CURTIS",
        "first_name": "DEBORA",
        "middle_name": "RUCKES",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-05",
        "last_updated": "2022-01-13",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704187285",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MI",
            "license": "4704187285",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.