Edla J Rucker, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

NURAPRNLIC235271 Issued in MT

Practice address

405 3Rd St NW Ste 102&103
Great Falls, MT 59404-4111

Phone

(406) 430-2035

NPI assigned

Aug 19, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NM, MT, OR3 enrollments

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 3

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edla@direct.mtbscc.org
• Direct secure messaging: edla.rucker.1@17520.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/12922/brand/1/csg/1/fhir/r4

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.

• Greater Good Health PC, Inc.

  • Primary Care Clinic/Center
  • Missoula, MT
  • NPI 1104503168

  MT

  Medicare reassignment NPD
• Gila Regional Medical Center

  • Medical Oncology Physician
  • Silver City, NM
  • NPI 1619053709

  NM

  Medicare reassignment NPD
• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Lordsburg, NM
  • NPI 1306843180

  NM

  Medicare reassignment NPD
• P3 Medical Group PC

  • Family Medicine Physician
  • Salem, OR
  • NPI 1689266926

  Nurse Practitioner, OR

  Medicare reassignment NPD
• Valued Medical Care LLC

  • Urgent Care Clinic/Center
  • West Jordan, UT
  • NPI 1578887329

  NM

  Medicare reassignment NPD
• Greater Good Health PC Inc

  • Primary Care Clinic/Center
  • Great Falls, MT
  • NPI 1386321354
  NPD
• Associates for Womens Health of Southern Oregon LLC

  • Obstetrics & Gynecology Physician
  • Medford, OR
  • NPI 1447392774
  NPD
• Gila Regional Medical Center

  • Critical Access Hospital
  • Silver City, NM
  • NPI 1336220839
  NPD
• Gila Regional Medical Center

  • Family Medicine Physician
  • Silver City, NM
  • NPI 1831555366
  NPD
• Greater Good Health PC, Inc.

  • Primary Care Clinic/Center
  • Ammon, ID
  • NPI 1033095914
  NPD
• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Silver City, NM
  • NPI 1467971986
  NPD
• Hidalgo Medical Services

  • Federally Qualified Health Center (FQHC)
  • Bayard, NM
  • NPI 1861432015
  NPD

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1467609784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 3RD ST NW STE 102&103",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594044111",
            "telephone_number": "406-430-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 3RD ST NW STE 102&103",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594044111",
            "telephone_number": "406-430-2035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 De Moss St",
            "address_purpose": "LOCATION",
            "city": "Lordsburg",
            "state": "NM",
            "postal_code": "880452617",
            "country_code": "US",
            "telephone_number": "575-542-8384",
            "fax_number": "575-542-2388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUCKER",
        "first_name": "EDLA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MT",
            "license": "NURAPRNLIC235271",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-03224",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "10100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810017550",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WV1240A",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01046643",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2943499",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natasha Rousseau
• Timothy P Roux, MD
• Judi L. Rowe, ATC
• Nancy Jo Rowell, FNP
• Pamella Mae Rozan, LCPC
• Shawn Allen Ruff, M.S. ATC
• Dennis P Ruggerie, DO
• Teriesa Black Runyan, LMT
• David Houston Rushing
• Betsy Rushworth, PHD

• All providers in Great Falls, MT
• Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.