Stanley Ruder, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704372138 Issued in MI

Practice address

1951 Oak St
Niles, MI 49120-3738

Phone

(269) 262-4749

Fax

(269) 262-4739

NPI assigned

Jan 9, 2017

Sex

Male

Sole proprietor

No

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

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Immediate Care CenterGroup PAC ID 2264423771, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sruder1271700@epic00.shdirect.org

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.

• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Cassopolis, MI
  • NPI 1982677548
  Medicare reassignment Care Compare group NPD
• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Niles, MI
  • NPI 1760802912
  NPD
• Lakeland Immediate Care Center

  • Federally Qualified Health Center (FQHC)
  • Dowagiac, MI
  • NPI 1881492338
  NPD
• Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1306048632
  NPD (past)
• Howard Brown Health Center

  • Health Educator
  • Chicago, IL
  • NPI 1811824121
  NPD (past)

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1477099935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1951 OAK ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491203738",
            "telephone_number": "269-262-4749",
            "fax_number": "269-262-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1951 OAK ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491203738",
            "telephone_number": "269-262-4749",
            "fax_number": "269-262-4739"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "261 M 62",
            "address_purpose": "LOCATION",
            "city": "Cassopolis",
            "state": "MI",
            "postal_code": "490311034",
            "country_code": "US",
            "telephone_number": "269-445-3874",
            "fax_number": "269-445-1930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDER",
        "first_name": "STANLEY",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-09",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704372138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Anne Rooney-Gandy, DO
• Rebekah Rose
• Rebekah Rose
• Kyle F Rotondo, FNP-C
• Mary Rozniak, MA, LLP
• Wendy Elizabeth Ruppart
• Tiffany Russell, LMSW
• Richard Ronald Rutkowski, D.D.S.
• RX Optical Laboratories, Inc.
• Kayleigh Sabat

• Psychiatric/Mental Health Nurse Practitioner in Niles, MI
• Providers in Niles, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.