Ruby Mountain Recovery

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Legal business name

RUBY MOUNTAIN RECOVERY

Practice address

1009 Silver St
Elko, NV 89801-3936

Phone

(775) 397-3486

NPI assigned

Nov 7, 2020

Organization subpart

No

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

Authorized official

Name

Sierra BradeenNPI 1548797392

Title

Owner

Phone

(775) 397-3486

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sierra Bradeen

  • Clinical Social Worker
  • Elko, NV
  • NPI 1548797392

  NV, Rehabilitation Practitioner

  Medicare reassignment NPD Authorized official
• Jacqueline A Volkmann, LCSW

  • Clinical Social Worker
  • Elko, NV
  • NPI 1023178399
  NPD (past)

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

{
    "created_epoch": "1604707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604707200000",
    "number": "1265033922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 WESTERN HLS UNIT 16",
            "city": "SPRING CREEK",
            "state": "NV",
            "postal_code": "898159722",
            "telephone_number": "775-397-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 SILVER ST",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898013936",
            "telephone_number": "775-397-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUBY MOUNTAIN RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-07",
        "last_updated": "2020-11-07",
        "certification_date": "2020-11-07",
        "status": "A",
        "authorized_official_last_name": "BRADEEN",
        "authorized_official_first_name": "SIERRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-397-3486"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruby Dome Anesthesia LLC
• Ruby Dome Pain Management LLC
• Ruby Mountain Chiropractic Center, Inc.
• Ruby Mountain Obstetrics and Gynecology
• Ruby Mountain Physical Therapy
• Ruby Mountain Resource Center
• Ruby Vista Therapy LLC
• William Ruebusch, RPH
• Arturo Ruiz Jr.
• Sonia Ruiz

• All providers in Elko, NV
• Rehabilitation Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.