Individual provider Active NPI

Darcy Dee Ruffo, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Coeur d'Alene, ID
National Provider Identifier
1366137705
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
67720 Issued in ID
Practice address
1250 W Ironwood Dr Ste 333
Coeur D Alene, ID 83814-2682
Phone
(208) 626-2433
Fax
(888) 325-5656
NPI assigned
Apr 11, 2023
Last updated
Jul 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 67720 ID
Psychiatric/Mental Health Registered Nurse 163WP0808X RN61222156 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP61415809 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 67720 ID Primary

Addresses

Primary practice location

1250 W Ironwood Dr Ste 333
Coeur D Alene, ID 83814-2682

Mailing address

1250 W Ironwood Dr Ste 333
Coeur D Alene, ID 83814-2682
Phone (208) 626-2433

Other identifiers 2

IdentifierTypeStateIssuer
21863175OtherNATIONAL COUNCIL OF STATE BOARDS OF NURSING (NCSBN)
2023018592OtherAMERICAN NURSES CREDENTIALING CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20240305001857 ID Practitioner - Certified Clinical Nurse Specialist (CNS) 0840635488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1250 W Ironwood Dr
Suite 333
Coeur D Alene, ID 83814-2682
Phone (208) 626-2433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
RN61222156WAMDPsychiatric/Mental Health Registered Nurse
AP61415809WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Psychiatry LLC Psychiatric/Mental Health CurrentSince Apr 12, 2024 Accepting new patients
Own Family Medicine and Wellness LLC Dba Active Family Healthcare PastSince Jan 6, 2024 Accepting new patients

Locations

1250 W Ironwood Dr
Ste 333
Coeur D Alene, ID 83814
Phone (208) 626-2433

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": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1366137705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 W IRONWOOD DR STE 333",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142682",
            "telephone_number": "208-626-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 W IRONWOOD DR STE 333",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142682",
            "telephone_number": "208-626-2433",
            "fax_number": "888-325-5656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUFFO",
        "first_name": "DARCY",
        "middle_name": "DEE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "ID",
            "license": "67720",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WA",
            "license": "RN61222156",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP61415809",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "67720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL COUNCIL OF STATE BOARDS OF NURSING (NCSBN)",
            "identifier": "21863175",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN NURSES CREDENTIALING CENTER",
            "identifier": "2023018592",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur d'Alene, ID

Sources for this page

Verify at the official NPI Registry.