Active NPI
Drew Ruckelshaus, ATC
- Athletic Trainer
- Oxford, OH
National Provider Identifier
1306386867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT003887
- Practice address
- 605 Oak St
Goggin Ice Center Room 130
Oxford, OH 45056 - Phone
- (513) 529-2358
- NPI assigned
- Mar 3, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT003887 | OH | Primary |
Addresses
Primary practice location
605 Oak St
Goggin Ice Center Room 130
Oxford, OH 45056
Mailing address
605 Oak St
Goggin Ice Center Room 130
Oxford, OH 45056
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT003887 | OH | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488499200000",
"number": "1306386867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 OAK ST",
"address_2": "GOGGIN ICE CENTER ROOM 130",
"city": "OXFORD",
"state": "OH",
"postal_code": "45056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "605 OAK ST",
"address_2": "GOGGIN ICE CENTER ROOM 130",
"city": "OXFORD",
"state": "OH",
"postal_code": "45056",
"telephone_number": "513-529-2358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUCKELSHAUS",
"first_name": "DREW",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-03",
"last_updated": "2017-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OH",
"license": "AT003887",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oxford, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.