Individual provider Active NPI

Jennifer Ruckstuhl, NP

  • Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1396126314
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.17339 Issued in OH
Practice address
1 Seagate Ste 800
Toledo, OH 43604-1558
Phone
(419) 785-7300
Fax
(419) 785-7322
NPI assigned
Jun 16, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA.17339-NP OH
Nurse Practitioner 363L00000X APRN.CNP.17339 OH Primary

Addresses

Primary practice location

1 Seagate Ste 800
Toledo, OH 43604-1558

Mailing address

1 Seagate Ste 800
Toledo, OH 43604-1558
Phone (419) 785-7300

Other identifiers 1

IdentifierTypeStateIssuer
0137676MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jruckstuhl7925@epicdirect.promedica.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150723008067 OH Practitioner - Nurse Practitioner 9830402569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians

Practice addresses (Care Compare)

1601 Brigham Dr
Suite 150
Perrysburg, OH 43551-7120
Phone (419) 872-7246

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.17339OHMDNurse Practitioner
COA.17339-NPOHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Promedica Central Physicians CurrentSince Oct 1, 2017 Accepting new patients
Promedica Central Physicians Nurse Practitioner CurrentSince Oct 1, 2017 Accepting new patients
Wood Health Company LLC CurrentSince Nov 1, 2015 Accepting new patients
Promedica Central Physicians PastSince Oct 16, 2022 Accepting new patients

Locations

745 Haskins Rd
Ste B
Bowling Green, OH 43402
Phone (419) 373-7607

838 E Wooster St
Bowling Green, OH 43402
Phone (419) 372-2271

141 N Keyser Ave
Deshler, OH 43516
Phone (419) 278-2065

6711 Airport Hwy
Holland, OH 43528
Phone (567) 585-0070

3316 Navarre Ave
Ste F
Oregon, OH 43616
Phone (419) 291-1420

2801 Bay Park Dr
Oregon, OH 43616
Phone (419) 690-7652

25950 Dixie Hwy
Perrysburg, OH 43551
Phone (567) 585-0010

1601 Brigham Dr
Ste 150
Perrysburg, OH 43551
Phone (419) 794-7700

4900 N McCord Rd
Ste A1B
Sylvania, OH 43560
Phone (567) 600-4598

1 Seagate
Ste 800
Toledo, OH 43604

3430 Secor Rd
Toledo, OH 43606
Phone (567) 585-0225

2109 Hughes Dr
Ste 450
Toledo, OH 43606
Phone (419) 251-3112

100 Madison Ave
Toledo, OH 43604
Phone (567) 585-1964

6755 W Central Ave
Ste 101
Toledo, OH 43617
Phone (567) 585-0075

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Otterbein Sunset VillageSylvania, OH, CCN 366242 Skilled nursing facility Managing Control - Governing Body
Trustee of the SNF
Jan 1, 2025
Jan 1, 2025
Otterbein Sunset HouseToledo, OH, CCN 366148 Skilled nursing facility Managing Control - Governing Body
Trustee of the SNF
Jan 1, 2025
Jan 1, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1434412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1396126314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "419-785-7300",
            "fax_number": "419-785-7322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SEAGATE STE 800",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436041558",
            "telephone_number": "419-785-7300",
            "fax_number": "419-785-7322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKSTUHL",
        "first_name": "JENNIFER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-16",
        "last_updated": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.17339-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.17339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137676",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jruckstuhl7925@epicdirect.promedica.org",
            "affiliation": "N",
            "address_1": "100 Madison Ave",
            "city": "Toledo",
            "state": "OH",
            "country_code": "US",
            "postal_code": "436041516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.