Randall David Rugg, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202210677NP-PP Issued in OR

Practice address

7105 SW Varns St Ste 270
Portland, OR 97223-8173

Phone

(503) 389-1500

NPI assigned

Jul 20, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Valuecore Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Canby, OR
  • NPI 1093444622
  NPD (past)

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

{
    "created_epoch": "1658275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1467187633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4207 SE WOODSTOCK BLVD # 429",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972066267",
            "telephone_number": "503-682-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7105 SW VARNS ST STE 270",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972238173",
            "telephone_number": "503-389-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUGG",
        "first_name": "RANDALL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-20",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202210677NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Michelle Ruff, D.O.
• Patricia Ruffin
• Jayla Shanice Ruffus-Milner
• Hannah Rufner
• Derek Rufo
• Rugged Heart Counseling LLC
• Rugged Heart Counseling LLC
• Leah Ruggiere
• David Rugh, C.R.M
• Paige Nicole Ruh, DO

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.