Individual provider Active NPI

Henry McKinley Rucker

  • Family Nurse Practitioner
  • Las Vegas, NV
National Provider Identifier
1407392855
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN002241 Issued in NV
Practice address
4580 S Eastern Ave Ste 29
Las Vegas, NV 89119-6100
Phone
(702) 954-4915
NPI assigned
Jan 10, 2017
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN002241 NV Primary

Addresses

Primary practice location

4580 S Eastern Ave Ste 29
Las Vegas, NV 89119-6100

Mailing address

4580 S Eastern Ave Ste 29
Las Vegas, NV 89119-6100
Phone (702) 954-4915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20180814003849 NV Practitioner - Nurse Practitioner 2062780042 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NV Always Your Doctor LLCGroup PAC ID 1355874090, 5 clinicians

Practice addresses (Care Compare)

3352 N Campbell Rd
Las Vegas, NV 89129-6166
Phone (702) 738-1503

4580 S Eastern Ave
Suite 29B
Las Vegas, NV 89119-6100
Phone (702) 954-4915

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71007065AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Instamobile Gregbairdnv PLLC CurrentSince Jan 1, 2026 Accepting new patients
NV Always Your Doctor LLC CurrentSince Mar 8, 2025 Accepting new patients
Luminity Care LLC CurrentSince Jan 21, 2026 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Feb 4, 2024 Accepting new patients
Charleston Residential Services LLC Past Accepting new patients
Medtrans Reno Casal PLLC Past Accepting new patients

Locations

701 S Carson St
Ste 200
Carson City, NV 89701
Phone (617) 586-0958

4580 S Eastern Ave
Ste 29B
Las Vegas, NV 89119
Phone (702) 954-4915

9510 W Sahara Ave
Ste 225
Las Vegas, NV 89117
Phone (702) 518-5144

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 6

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": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1407392855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 S EASTERN AVE STE 29",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196100",
            "telephone_number": "702-954-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 S EASTERN AVE STE 29",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196100",
            "telephone_number": "702-954-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "HENRY",
        "middle_name": "MCKINLEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-10",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.